Revenue Recovery Specialist II

Spec Ii Revenue Recovery

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 Spec II Revenue Recovery will be responsible for researching and analyzing accounts to ensure that underpayments are identified and recovered. The Specialist will determine the appropriate action needed to recovery the underpayment, complete the action, and follow up on the underpayment through recovery of the outstanding monies. Duties include identifying and recovering underpayments on patient accounts. The Specialist will develop a strong working relationship with the client team and counterparts in Contract Management and will work reports and assigned tasks as they are assigned.

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.

Job Experience :

One (1) to three (3) years of experience in the hospital or physician insurance industry, or elsewhere in the revenue cycle, strongly preferred.

Desired Education Level :

High school diploma or GED.

Preferred Knowledge, Skills + Abilities :

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 :

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.