Senior Accounts Receivable Specialist

Ensemble Health Partners; New York (NY); On-site; USD 25,000 - 29,000; Full time

Benefits offered by this job

Bonus Incentives

Paid Certifications

Tuition Reimbursement

Comprehensive Benefits

Career Advancement

Job summary

Ensemble Health Partners in the United States seeks a Sr Specialist, Accounts Receivable to manage follow up and denial activities with commercial, governmental, and other payers, ensuring timely reimbursement.

You will identify payment trends, advise on process improvements, and mentor AR Specialists to strengthen the denials and appeals workflow while supporting leadership on cash acceleration initiatives.

Qualifications

• Experience in healthcare AR follow-up and denial resolution.
• Ability to communicate with payers to resolve payment variances.
• Familiarity with appeals processes and claim management.

Responsibilities

• Perform follow up with payers to resolve claim issues and ensure timely reimbursement.
• Identify denial trends and recommend remediation actions to leadership.
• Mentor AR Specialist team members to improve denials and appeals process.
• Take meeting minutes for payor-related discussions and escalate issues as needed.

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:CAREER OPPORTUNITY OFFERING:

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

This position pays between $18.65 - $20.50/hr based on experience

The Sr Specialist, Accounts Receivable performs all follow up and denial activities. 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 trends in denied payments by insurance companies to remediate issues, identifies changes with insurance company policies to ensure compliant billing, communicates with other departments to resolve denial issues and submits technical and clinical appeals in a timely manner. Will mentor the AR Specialist team members to help develop and improve their skills in the follow up, denials and appeals process. Follows up on clean claim delays from payors and adds issues to the escalation spreadsheets. Assists leadership with special projects for AR reduction and Cash Acceleration.Mentors AR Specialist team members to help develop and improve their skills in the denials and appeals process.

Examines denied and other non-paid claims to determine reason for discrepancies.

Demonstrates initiative in resolving complex claims and proactively makes recommendations to management on specific trends or necessary interventions.

Communicates directly with payers to follow up on outstanding claims, files technical and clinical appeals, resolve payment variances, and ensures timely and accurate reimbursement.

Provides guidance to other team members on resolving complex claims and filing appeals.

Ability to identify with specific reason underpayments, denials, and cause of payment delay. Works with management to identify, trend, and address root causes of issues in the A/R.

Takes meeting minutes for payor