Denial Prevention Service Line Analyst

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!

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 $46,900 - $89,850 based on experience

The Service Line Analyst, Denial Prevention performs data analysis on clinical and technical denials for assigned client(s) and operational area(s) utilizing multiple analytics tools (including parsed 835 data, Epic BDC records, Access databases/SQL) to identify patterns and trends relative to acute denials.

Applies high level problem-solving skills to perform root cause analysis on denied accounts and extrapolates those causes across large volumes identified as denial trends for assigned client(s).

Collaborates with the Client Relationship Supervisor, Denial Prevention, to develop recommendations for process improvement.

Uses process improvement expertise and persuasion skills to guide and influence subject matter experts through assessments of operations and preparation of policies, procedures, and tip sheets that assist in remedying the root cause(s).

Is client-facing and works with leaders in other internal departments.

Performs all duties respectfully and professionally, meeting the Mission of Ensemble Health Partners, the patients and clients we serve.

Essential Job Functions:

• Using defined monthly denial reports, performs deep dive analysis of denied accounts identifying: 1) denial root causes for short- and long-term solution planning; 2) trends in high dollar and/or volume denials for greatest focus and impact; 3) long-term reduction in final write-offs and net patient service revenue. From analysis, documents findings into defined templates for initial presentation and targeting of existing processes/procedures/education needs for further assessment and review
• Assists the Client Relationship Supervisor, Denial Prevention in providing supplemental information relative to identified trends, progress from prior actions, and next steps. Establishes complimentary relationships with appropriate stakeholders/committee members, including Finance Leadership, Revenue Cycle, Managed Care, hospital ancillary department heads, and other leaders as needed.
• Produces documentation and trends prevention-related findings into defined templates, creates reports or summaries as needed. Performs reviews using all patient accounting, host, Epic and related systems used across their client to verify and summarize trends concisely and actionably. Collaborates with Client Relationship Supervisor, Denial Prevention on communicating issues to the Client(s).
• Submits to Service Line Supervisor, Denial Prevention process improvement recommendations to remedy people, process, and technology issues that cause denials.
• Creates materials and assists in training revenue cycle site directors, committee members, and revenue cycle staff as necessary on denials-related trends and issues impacting their client
• Travels as needed to Client(s) as needed
• Performs other duties as assigned

Employment Qualifications:

Minimum years and type of experience:

• 3-5 years of acute revenue cycle

Other knowledge, skills, and abilities preferred:

• Project work, Intermediate Excel and Access, Data Analytics
• Project Management

Minimum Education:

• High School Dipl