Senior Billing SME Operator

Ensemble Health Partners • Austin, TX

1d • 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. Essential Duties & Responsibilities Core 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. Role-Specific Responsibilities: 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. Qualifications Required Qualifications: 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. This is a hybrid role based in Austin, Texas. Candidates must be able to commute to the Austin on-site location as required. Senior-Level Individual Contributor Expectations: 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. Core Competencies 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 Work Style & Environment This role operates in a rapid-iteration environment and requires comfort with ambiguity, experimentation, and cross-functional collaboration. The Senior Operator is expected to challenge existing processes respectfully, propose improvements, and help validate automation and AI-driven solutions using real operational scenarios. Equal Opportunity Statement Ensemble Health Partners is an Equal Opportunity / Affirmative Action Employer. We welcome and encourage diversity in our workplace. Join an award-winning company Five-time winner of “Best in KLAS” 2020-2022, 2024-2025 Black Book Research's 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 Group's RCM Operations PEAK Matrix Assessment 2024 Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023 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 Health Partners 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 Health Partners also prohibits harassment of applicants or employees based on any of these protected categories. Ensemble Health Partners 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 [email protected]. 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 role’s range. EEOC – Know Your Rights FMLA Rights - English La FMLA Español E-Verify Participating Employer (English and Spanish) Know your Rights Legitimate Ensemble Health Partners Recruiters will only contact you from an email address ending in “@ensemblehp.com.” Don’t fall victim to fake job postings from fraudsters posing as Ensemble Health Partners Human Resources personnel. Ensemble Health Partners will never ask for a payment in exchange for a job opportunity or ask you to submit sensitive personal information via email, phone, form, app or text. Ensemble Health Partners is dedicated to providing our clients with experienced healthcare finance and revenue cycle professionals. We believe that our core values of trust, integrity, loyalty and service married with the belief that our work is worthwhile helps us build and sustain sincere relationships with our associates and clients. If you are a passionate, dedicated and experienced revenue cycle, consulting or finance professional and seek career and personal growth, we would love to hear from you. We believe we foster an environment where talented individuals can excel and shine. Our team believes that people are the most important part of our success and that when we take care of our people, they pay it forward by providing our clients with excellent results and world-class service.

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.

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