Senior Revenue Recovery Specialist - Physicians

Ensemble Health Partners•Work at Home - Ohio - Other, OH

19d•$22 - $25•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. This position is responsible for working with a team of associates that research and analyze accounts to ensure that underpayments are identified and recovered. The Specialist will determine the appropriate action needed to recover the underpayment, complete the action, and follow up on the underpayment through recovery of the outstanding monies. The position will require the ability to multitask within the client team.

Requirements

Three (3) to five (5) years of experience in the physician insurance industry or elsewhere in the revenue cycle, required.
Excellent verbal and written communication skills.
Professional 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.
Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences.

Responsibilities

Identify and recover underpayments on patient accounts.
Develop a strong working relationship with the client team and counterparts in Contract Management.
Work reports and assigned tasks as they are assigned.
Find underpayments through both prediction rules and special assignments as required by leadership.
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 with minimal direction.
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, independently solving problems.
Meet all productivity and quality standards as established by Ensemble.
Identify underpayments through both automated and manual means.
Multitask within the client team.