Senior Billing SME Operator

Ensemble Health Partners • Austin, TX

18h • Hybrid

About The Position

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: Job Summary The Senior Billing SME Operator is a senior-level individual contributor responsible for analyzing claim edits, rejections, and delays, designing future-state billing workflows, and translating billing logic into structured rule sets suitable for automation and AI. Role Overview Operators serve as subject matter experts in specific revenue cycle domains while maintaining literacy across the end-to-end revenue cycle. They redesign workflows, identify upstream root causes, build knowledge graphs, participate in design sessions, and validate emerging automation and AI-driven models.

Requirements

• 5+ years of hands-on experience in the revenue cycle domain aligned to this role.
• Strong end-to-end revenue cycle literacy.
• Exceptional process mapping and process improvement capability.
• Data-driven problem solving and comfort with variance analysis.
• Ability to operate effectively in ambiguity; self-motivated and proactive.
• Strong communication skills for both technical and non-technical audiences.
• Curiosity and aptitude for automation, ML/AI, and agentic technologies.
• Demonstrated ability to lead problem-solving and redesign efforts independently (without formal authority).
• Proven ability to challenge existing processes constructively and propose more efficient methods.
• Comfort partnering closely with engineering/product teams to define, test, and iterate solutions.
• Ability to translate complex operational judgment into structured logic suitable for automation or AI.
• Innovative thinking and solutioning mindset
• Creative problem solving and systems thinking
• Comfort challenging existing processes to identify better, more efficient methods
• Interest in and practical familiarity with AI-enabled workflows and automation
• Strong stakeholder communication and collaboration

Responsibilities

• Act as the domain SME while maintaining literacy across the full revenue cycle.
• Identify structural root causes that drive downstream rework, friction, and leakage.
• Design future-state workflows and operating models with measurable impact.
• Build and maintain domain-specific knowledge graphs capturing inputs, rules, actions, and outcomes.
• Participate in design sessions and rapid innovation sprints with product, engineering, and analytics teams.
• Test and validate automation, ML, AI, and agentic models using real operational scenarios.
• Translate SME judgment into rules, decision trees, training data, and guardrails.
• Support pilots and controlled rollouts with clear success criteria and measurement.
• Document operational logic and findings for reuse and scale.
• Analyze systemic causes of claim edits, rejections, and delays.
• Design workflows that increase clean claim rates by addressing upstream issues.
• Translate billing logic into structured rule sets and model-ready logic.
• Partner with engineering to improve data integrity and orchestration.

Benefits

• 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.
• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed