Job Description

Thank you for considering a career at Ensemble!

Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.

Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo we know they will be the difference!

O.N.E Purpose:

• Customer Obsession: Consistently provide exceptional experiences for our clients patients and colleagues by understanding their needs and exceeding their expectations.

• Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.

• Striving for Excellence: Execute at a high level by demonstrating our Best in KLAS Ensemble Difference Principles and consistently delivering outstanding results.

The Opportunity:

CAREER OPPORTUNITY OFFERING:

• Bonus Incentives
• Paid Certifications
• Tuition Reimbursement
• Comprehensive Benefits
• Career Advancement
• This position pays between $45000.00 - $81750.00/ based on experience and other factors.

The Analyst I is a subject matter expert that is responsible for the maximation of insurance reimbursement by identifying contractual variances between posted payments and expected reimbursement for managed care government payors and other payors as needed. The responsibilities include contractual reimbursement analysis and communication of payment discrepancies to both internal and external departments. The Specialist identifies trends in underpayments and determines effective paths to work to resolution of the underpayments and improvement to the revenue cycle going forward. Other responsibilities include analyzing and interpreting contract reimbursement and providing feedback to leadership as required. The Specialist will consistently review large amounts of remittance data to locate charge or billing opportunities for revenue optimization.

Essential Job Functions:

• Communicate directly with payors to follow up on outstanding underpayments file underpayment appeals with payors resolve account variance and ensure timely and accurate recovery of underpayments.

• Identify root cause of underpayments denials and delayed payments to clients. Work with the client team to identify document and address root causes of issues in the A/R.

• Maintain a thorough understanding of applicable state and federal insurance regulations as well as payor specific requirements taking actions on underpayments accordingly.

• Document all activity accurately with all pertinent information in the clients host system Ensemble IQ or other appropriate tracking system.

• Demonstrate initiative and resourcefulness by making recommendations and communicating trends and issues to management.

• Operate as a strong problem solver and critical thinker to resolve underpayments.

• Meet all productivity and quality standards as established by Ensemble and Revenue Recovery leadership.

• Compile and analyze data to identify underpayments and trends in the underpayments and report to leadership findings in a timely and consistent manner.

• Work collaboratively with other departments including Managed Care Billing Coding Revenue Integrity and Payor Strategy.

• Work multiple projects reports and tasks efficiently in a fast-paced KPI-driven atmosphere autonomously.

Job Experience:

Minimum five (5) years of experience in the hospital or physician insurance industry or elsewhere in the revenue cycle required. Applicants must have a keen and proven understanding of the revenue cycle and the identification of underpaid accounts.

Desired Education :

Bachelors degree preferred but not required. High school diploma or GED required.

Required Knowledge Skills and Abilities:

• Excellent verbal and written communication skills.
• Profession presence.
• Exceptional customer service.
• Ability to adapt to multiple client host systems.
• Integrity and honesty.
• Internal drive to succeed.
• Experience with and ability to operate in Microsoft Office suite of programs.

• Demonstrated advanced usage of AI and the management of teams using AI to lean in to process and technological improvements to include the exploration experimentation and application of AI.

• This is a remote position; however candidates must be willing and able to travel to and work onsite at client temporary or corporate office locations as business needs require.

Join an award-winning company

Five-time winner of Best in KLAS

Black Book Researchs Top Revenue Cycle Management Outsourcing Solution 2021-2024

22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024

Leader in Everest Groups RCM Operations PEAK Matrix Assessment 2024

Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance-2023

Energage Top Workplaces USA 2022-2024

Fortune Media Best Workplaces in Healthcare 2024

Monster Top Workplace for Remote Work 2024

Great Place to Work certified 2023-2024

• Innovation

• Work-Life Flexibility

• Leadership

• Purpose Values

Bottom line we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:

• Associate Benefits We offer a comprehensive benefits package designed to support the physical emotional and financial health of you and your family including healthcare time off retirement and well-being programs.

• Our Culture Ensemble is a place where associates can do their best work and be their best selves. We put people first last and always. Our culture is rooted in collaboration growth and innovation.

• Growth We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.

• Recognition We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.

Ensemble is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race color sex sexual orientation gender gender identity religion national origin age disability military or veteran status genetic information or any other basis protected by applicable federal state or local laws. Ensemble also prohibits harassment of applicants or employees based on any of these protected categories.

Ensemble provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process please contact .

This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the roles range.

Required Experience:

IC

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