Senior Accounts Receivable Specialist

Ensemble Health Partners; United States; Remote; USD 26,000 - 28,000; Full time

Benefits offered by this job

Bonus Incentives

Paid Certifications

Tuition Reimbursement

Comprehensive Benefits

Career Advancement

Job summary

Ensemble Health Partners seeks a Sr Specialist, Accounts Receivable to manage follow up and denial activities with commercial, governmental payers; ensure timely reimbursement and identify denial trends.

You will mentor AR Specialists, document activity, maintain regulatory knowledge, and collaborate with management on process improvements; this is a remote position with travel to client sites as needed.

Qualifications

• Must have AR/FOLLOW-UP experience with denials and appeals.
• Proficiency in Excel and payer portal tools.
• Strong communication and problem-solving skills.

Responsibilities

• Follow up with commercial, governmental payers to secure timely reimbursement.
• Identify trends in denied payments and remediate issues.
• Mentor AR Specialist team members and assist with process improvements.
• Document all activity accurately in client systems.

Skills

Accounts Receivable

Denials & Appeals

Payer follow-up

Excel proficiency

Communication skills

Education

High School Diploma

Tools

DDE Medicare system

Payer websites

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.

Responsibilities

• 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.
• 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 escalation calls and provides feedback to the AR associates key takeaways from the calls.
• 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.
• Reviews escalations from other areas to AR as well as accounts that require escalation to other areas of Revenue Cycle.
• Assists the supervisor with DIBS calls as needed.
• Needs to be a strong problem solver and critical thinker to resolve accounts.
• Must meet productivity and quality standards as established by Ensemble.
• Performs other duties as assigned, including projects.

Required License / Certification

Ensemble Required License / Certification (Ex: CRCR) ONE CERTIFICATION PER FIELD CRCR, either upon hire or within 9 months of hire. (Or other approved job relevant certification, as approved by SVP of department.)

Job Experience

1 to 3 Years

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.

Education Level

High School Diploma, GED, or Equivalent Experience

Expected Knowledge, Skills and Abilities

Must demonstrate basic computer knowledge and demonstrate proficiency in Microsoft Excel.

Internal candidate must have met 120% Productivity and 98% Quality Assurance in each of the previous 3 months. External candidates must meet quality and productivity standards by day 90. Failure to meet this standard will result in demotion to AR Specialist and will become eligible to re-apply for Sr AR Specialist 90 days following the demotion. Excellent Verbal skills. Problem solving skills, the ability to look at account 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.

Other 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 Purpose + Values Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive.

Associate Benefits

We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.

Culture

Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.

Growth

We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.

Recognition

We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.

Equal Opportunity Statement

Ensemble 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 also prohibits harassment of applicants or employees based on any of these protected categories.

US Work Authorization

Due to business, operational, payroll, and regulatory requirements, this position is limited to individuals who reside and are authorized to work within the United States. Applications generated from outside the United States will not be considered. Individuals may reapply when located within the United States. Ensemble 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 [e-mail].

Pay Transparency

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.

Legal and Fraud Disclaimers

Ensemble is dedicated to providing our clients with experienced healthcare finance and revenue cycle professionals. We believe that our core values of trust, integrity, loyalty and service married with the belief that our work is worthwhile helps us build and sustain sincere relationships with our associates and clients.

Join Us

If you are a passionate, dedicated and experienced revenue cycle, consulting or finance professional and seek career and personal growth, we would love to hear from you. We believe that we foster an environment where talented individuals can excel and shine. Our team believes that people are the most important part of our success and that when we take care of our people, they pay it forward by providing our clients with excellent results and world-class service.