Senior Analyst, Revenue Recovery

Ensemble Health Partners; United States; Remote; USD 66,000 - 99,000; Full time

Benefits offered by this job

Bonus Incentives

Paid Certifications

Tuition Reimbursement

Comprehensive Benefits

Career Advancement

Job summary

Ensemble Health Partners is seeking an Sr Analyst, Revenue Recovery to maximize insurance reimbursement by identifying contractual variances and analyzing remittance data for managed care and government payors. The role includes communicating payment discrepancies, identifying underpayments, and driving revenue cycle improvements.

The candidate will mentor the team, work with multiple departments, and support leadership in payor escalations while leveraging Ensemble IQ prediction rules and

Qualifications

• Minimum of five (5) years of experience in the hospital or physician insurance industry.
• CRCR certification within 9 months of hire.
• Excellent verbal and written communication skills.
• Professional presence with integrity and honesty.
• Experience with and ability to operate in Microsoft Office suite of programs.

Responsibilities

• Identify underpayments, denials, and delayed payments and determine effective paths to resolution.
• Review remittance data to locate charge or billing opportunities for revenue optimization.
• Communicate with payors to follow up on outstanding underpayments and file underpayment appeals as needed.
• Mentor and provide subject matter guidance to team members.
• Collaborate with client teams and other departments (Managed Care, Billing, Coding, Revenue Integrity, Payor Strategy).
• Assist leadership with client and payor escalations and support initiatives.

Skills

Customer Obsession

Embracing New Ideas

Striving for Excellence

Education

High School Diploma/GED or equivalent

Bachelor's degree preferred

Tools

Microsoft Office

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 will pay between $66,300 - $99,450/annually based on experience.

By embodying our core purpose of customer obsession, new ideas, and driving innovation, and delivering excellence, you will help ensure that every touchpoint is meaningful and contributes to our mission of redefining the possible in healthcare.

The Sr Analyst, Revenue Recovery is a subject matter expert that is responsible for the maximation of insurance reimbursement by identifying contractual variances between posted payments and ethe expected reimbursement for managed care, government payors, and other payors as needed. The responsibilities include contractual reimbursement analysis and communication of payment discrepancies to both internal and external departments. The Analyst identifies trends in underpayments and determines effective paths to work to resolution of the underpayments and improvement to the revenue cycle going forward. Other responsibilities include analyzing and interpreting contract reimbursement and providing feedback to leadership as required. Analyst will consistently review large amounts of remittance data to locate charge or billing opportunities for revenue optimization. The Sr Analyst will also assist leadership with initiatives, assist with client and payor escalations and be fully competent in all aspects of the EIQ Revenue Recovery prediction rules. The position will also complete assigned projects and serve as a mentor and subject matter expert to the team.

• 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.
• 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.
• 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.
• Meet all productivity and quality standards as established by Ensemble and Revenue Recovery leadership.
• Compile and analyze data to identify underpayments, and trends in the underpayments and report to leadership findings in a timely and consistent manner.
• Work collaboratively with other departments, including Managed Care, Billing, Coding, Revenue Integrity, and Payor Strategy.
• Work multiple projects, reports, and tasks efficiently in a fast-paced, KPI-driven, atmosphere autonomously.
• Coordinate with leadership to guide client team and all Ensemble and team initiatives.
• Assist leadership in client and payor escalations to recovery underpayments quickly and efficiently.
• Have a keen understanding and experience with Ensemble IQ underpayment prediction rules and how they are utilized to identify underpayments.
• Participate in self-directed projects as assigned by leadership.
• Serve as a mentor and subject matter expert to other associates on the client team.

Ensemble Required License / Certification (Ex: CRCR) ONE CERTIFICATION PER FIELD

• CRCR - (Certified Revenue Cycle Representative) required within 9 months of hire

People Leadership Experience

• 5 to 7 Years

Preferred Area of Study

• High School Diploma, GED, or Equivalent Experience

Other Preferred Knowledge, Skills and Abilities

• Minimum of at least five (5) years of experience in the hospital or physician insurance industry, or elsewhere in the revenue cycle, required. Applicants must have a keen and proven understanding of the revenue cycle and the identification of underpaid accounts.
• Bachelors degree preferred, but not required. High school diploma or GED required.
• Excellent verbal and written communication skills.
• Profession 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.

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. A few of those include:

• 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.
• Our 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.

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.

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].

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.

Employment Disclaimers – Ensemble