Accounts Receivable Specialist

Thank you for considering a career at Ensemble Health Partners!

Ensemble Health Partners 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

The Opportunity:

­­­­Accounts Receivable Specialist is responsible for following up directly with commercial, governmental, and other payers to resolve claim payment issues, to secure appropriate and timely reimbursement and response. Identifies and analyzes denials, payment variances, and no response claims and acts to resolve claims/accounts, including drafting and submitting technical and clinical appeals. Provides support for all denial, no response, and audit activities.

Essential Job duties:

• Examines denied and other non-paid claims to determine reason for discrepancies.
• Communicates directly with payers to follow up on outstanding claims, files technical and clinical appeals, resolves payment variances, and ensures timely and accurate reimbursement.
• Ability to identify with specific reason underpayments, denials, and cause of payment delay. Works with management to identify, trend, and address root causes of issues in the A/R.
• Maintains a thorough understanding of federal and state regulations, as well as payer specific requirements and takes appropriate action accordingly.
• Documents all activity accurately including contact names, addresses, phone numbers, and other pertinent information in the client’s host system and/or appropriate tracking system.
• Demonstrates initiative and resourcefulness by making recommendations and communicating trends and issues to management.
• Needs to be a strong problem solver and critical thinker to resolve accounts.

Expected Knowledge, Skills and Abilities:

• Must demonstrate basic computer knowledge and demonstrate proficiency in Microsoft Excel.
• Excellent Verbal skills.
• Problem solving skills, the ability to look at accounts and determine a plan of action for collection.
• Critical thinking skills, the ability to comprehend tools provided for securing payment, and apply them to differing accounts to result in payment.
• Adaptability to changing procedures and growing environment.
• Meet quality and productivity standards within timelines set forth in policies.
• Meet required attendance policies.

Preferred Knowledge, Skills, and Abilities:

• 2 or 4-year college degree.
• 1 or more years of relevant experience in medical collections, physician/hospital operations, AR Follow-up, denials & appeals, compliance, provider relations or professional billing preferred.
• Knowledge of claims review and analysis.
• Working knowledge of revenue cycle.
• Experience working the DDE Medicare system and using payer websites to investigate claim statuses.
• Working knowledge of medical terminology and/or insurance claim terminology.

Join an award-winning company

Three-time winner of “Best in KLAS” 2020-2022

2022 Top Workplaces Healthcare Industry Award

2022 Top Workplaces USA Award

2022 Top Workplaces Culture Excellence Awards

• 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 ince