Accounts Receivable Specialist

ensemblehp; United States; Remote; USD 22,000 - 25,000; Full time

Job summary

Ensemble is seeking an Accounts Receivable Specialist for a remote-entry level role. You will follow up with commercial and government payers to resolve claim issues and secure timely reimbursement. You will analyze denials, prepare appeals, and support denial, no-response, and audit activities.

The role emphasizes Excel proficiency, strong communication, and problem solving to identify root causes and improve processes. Remote work is available with potential onsite travel as needed.

Qualifications

• Must have basic computer knowledge and be proficient in Microsoft Excel.
• Excellent verbal skills.
• Problem solving skills to analyze accounts and plan actions for collections.
• Critical thinking to apply tools for securing payment across accounts.
• Adaptability to changing procedures and growing environment.
• Meet quality and productivity standards within policies and attendance requirements.

Responsibilities

• Examine denied and other non-paid claims to determine discrepancies.
• Communicate with payers to follow up on outstanding claims and submit appeals.
• Identify reasons for underpayments, denials, or delays and work with management to address root causes.
• Maintain understanding of federal/state regulations and payer requirements.
• Document activity in the client’s host system or tracking system.
• Propose improvements and communicate trends to management.
• Demonstrate problem-solving to resolve accounts.

Skills

Microsoft Excel

Verbal communication

Problem solving

Critical thinking

Adaptability

Attendance policies

Education

2- or 4-year college degree

Job description

Thank you for considering a career at Ensemble!

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. 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:

ENTRY LEVEL CAREER OPPORTUNITY OFFERING:

• Bonus Incentives
• Paid Certifications
• Tuition Reimbursement
• Comprehensive Benefits
• Career Advancement

This position pays between $16.50 - $18.65/hr based on experience

Accounts Receivable Specialist is responsible for following up directly with commercial, governmental, and other payers to resolve claim payment issues, to secure appropriate and timely reimbursement and response. Identifies and analyzes denials, payment variances, and no response claims and acts to resolve claims/accounts, including drafting and submitting technical and clinical appeals. Provides support for all denial, no response, and audit activities.

Essential Job duties:

• Examines denied and other non-paid claims to determine the reason for discrepancies.
• Communicates directly with payers to follow up on outstanding claims, files technical and clinical appeals, resolves payment variances, and ensures timely and accurate reimbursement.
• Ability to identify specific reasons for underpayments, denials, and cause of payment delay. Works with management to identify, trend, and address root causes of issues in the A/R.
• Maintains a thorough understanding of federal and state regulations, as well as payer specific requirements and takes appropriate action accordingly.
• Documents all activity accurately including contact names, addresses, phone numbers, and other pertinent information in the client's host system and/or appropriate tracking system.
• Demonstrates initiative and resourcefulness by making recommendations and communicating trends and issues to management.
• Needs to be a strong problem solver and critical thinker to resolve accounts.

Expected Knowledge, Skills and Abilities:

• Must demonstrate basic computer knowledge and demonstrate proficiency in Microsoft Excel.
• Excellent Verbal skills.
• Problem solving skills, the ability to look at accounts and determine a plan of action for collection.
• Critical thinking skills, the ability to comprehend tools provided for securing payment, and apply them to differing accounts to result in payment.
• Adaptability to changing procedures and growing environment.
• Meet quality and productivity standards within timelines set forth in policies.
• Meet required attendance policies.
• 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.

This is a remote position; however, candidates must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require.

Preferred Knowledge, Skills, and Abilities:

• 2 or 4-year college degree.
• 1 or more years of relevant experience in medical collections, physician/hospital operations, AR Follow-up, denials & appeals, compliance, provider relations or professional billing preferred.
• Knowledge of claims review and analysis.
• Working knowledge of revenue cycle.
• Experience working the DDE Medicare system and using payer websites to investigate claim statuses.
• Working knowledge of medical terminology and/or insurance claim terminology.

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 Purpo