Senior Denials Prevention Process Improvement Advisor

Ensemble RCM; United States; Remote; USD 69,000 - 103,000; Full time

Benefits offered by this job

Bonus Incentives

Paid Certifications

Tuition Reimbursement

Comprehensive Benefits

Career Advancement

Job summary

Ensemble, a leading provider of revenue cycle management solutions, is seeking a Senior Denials Prevention Process Improvement Advisor in the United States. The role serves as a subject matter expert to reduce clinical and technical denials by driving root-cause analysis and implementing sustainable process enhancements across the revenue cycle.

This position emphasizes collaboration with operational leaders and payer relations teams to improve first-pass yield.

Qualifications

• Associate degree; 2–5 years of relevant experience.

Responsibilities

• Conducting data-driven assessments of denial drivers, developing and deploying best practices, facilitating cross-functional workshops, and monitoring the effectiveness of implemented solutions through KPIs such as denial rate reduction and appeal avoidance.
• The Senior Advisor also partners with IT and compliance teams to optimize workflows and ensure adherence to regulatory and contractual requirements.

Education

Associate 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:

CAREER OPPORTUNITY OFFERING:

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

This position pays between $ 68,500-$103,000 based on experience

The Senior Denials Prevention Process Improvement Advisor serves as a subject matter expert and strategic partner in reducing clinical and technical denials across the revenue cycle by driving root cause analysis and implementing sustainable process enhancements. This role focuses on identifying denial trends, collaborating with operational leaders and payer relations teams, and designing preventive strategies that improve first-pass yield and reduce rework.

Key responsibilities:

• Conducting data-driven assessments of denial drivers, developing and deploying best practices, facilitating cross-functional workshops, and monitoring the effectiveness of implemented solutions through KPIs such as denial rate reduction and appeal avoidance.
• The Senior Advisor also partners with IT and compliance teams to optimize workflows and ensure adherence to regulatory and contractual requirements.

Required experience:

• Associate degree; 2 to 5 years of relevant experience.
• 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.

Desired experience:

• Experience in healthcare or technology operations preferred.

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