Senior Revenue Recovery Specialist - Physicians

Sr. Revenue Recovery Specialist

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!

The Sr. Revenue Recovery Specialist will be 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. Duties include identifying and recovering underpayments on patient accounts. The Specialist will develop a strong working relationship with the client team and counterparts in Contract Management and will work reports and assigned tasks as they are assigned. The Specialist will have the ability to find underpayments through both prediction rules and special assignments as required by leadership. The position will require the ability to multitask within the client team.

Essential Job Functions :

• 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 and
• Identify underpayments through both automated and manual means.
• Multitask within the client team.

Job Experience : Three (3) to five (5) years of experience in the physician insurance industry or elsewhere in the revenue cycle, required.

Desired Education Level : High school diploma or GED.

Preferred Knowledge, Skills :

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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 TA@ensemblehp.com.

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.