Revenue Recovery Analyst I

Analyst I

Ensemble Health Partners 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!

The Analyst I is a subject matter expert that is responsible for the maximization of insurance reimbursement by identifying contractual variances between posted payments and 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 Specialist 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. The Specialist will consistently review large amounts of remittance data to locate charge or billing opportunities for revenue optimization.

Essential Job Functions :

• 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.

Job Experience : Minimum 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.

Desired Education : Bachelor's degree preferred, but not required. High school diploma or GED required.

Other Preferred Knowledge, Skills and Abilities :

Join an award-winning company :

Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include :

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

Ensemble Health Partners 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 TA@ensemblehp.com.

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.