Revenue Recovery Associate Analyst I

Ensemble Health Partners•Columbia, SC

3d•Remote

About The Position

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.

Requirements

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.
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.

Nice To Haves

Bachelor’s degree preferred, but not required.

Responsibilities

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 client’s 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.
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.
Communicate payment discrepancies to both internal and external departments.
Identify trends in underpayments and determine effective paths to work to resolution of the underpayments and improvement to the revenue cycle going forward.
Analyze and interpret contract reimbursement and providing feedback to leadership as required.
Consistently review large amounts of remittance data to locate charge or billing opportunities for revenue optimization.