Senior Revenue Recovery Specialist
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. The company emphasizes a human touch in healthcare and empowers its people to challenge the status quo. Their O.N.E Purpose focuses on Customer Obsession, Embracing New Ideas, and Striving for Excellence. The Sr. Revenue Recovery Specialist will work with a team to research and analyze accounts, identify and recover underpayments, and determine appropriate actions to recover outstanding monies. This role involves identifying and recovering underpayments on patient accounts, developing strong relationships with client teams and Contract Management counterparts, and working on assigned reports and tasks. The Specialist will be able to find underpayments through prediction rules and special assignments and will need to multitask within the client team.
Requirements
- Three (3) to five (5) years of experience in the hospital or physician insurance industry, or elsewhere in the revenue cycle, required.
- 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.
- High school diploma or GED.
- Willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require.
Nice To Haves
- 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.
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 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.
Benefits
- Bonus Incentives
- Paid Certifications
- Tuition Reimbursement
- Comprehensive Benefits
- Career Advancement
- Healthcare
- Time off
- Retirement
- Well-being programs
- Professional development (Each associate will earn a professional certification relevant to their field)
- Quarterly and annual incentive programs
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
High school or GED
Number of Employees
501-1,000 employees
