Note: The job is a remote job and is open to candidates in USA. Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems. The Accounts Receivable Specialist is responsible for resolving claim payment issues, securing timely reimbursements, and analyzing denials and payment variances.

Responsibilities

• Examines denied and other non-paid claims to determine the reason for discrepancies
• Communicates directly with payers to follow up on outstanding claims, files technical and clinical appeals, resolves payment variances, and ensures timely and accurate reimbursement
• Ability to identify specific reasons for underpayments, denials, and cause of payment delay. Works with management to identify, trend, and address root causes of issues in the A/R
• 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
• Needs to be a strong problem solver and critical thinker to resolve accounts

Skills

• Must demonstrate basic computer knowledge and demonstrate proficiency in Microsoft Excel
• Excellent Verbal skills
• Problem solving skills, the ability to look at accounts 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
• 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
• 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

Benefits

• Bonus Incentives
• Paid Certifications
• Tuition Reimbursement
• Comprehensive Benefits
• Career Advancement
• 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.
• Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
• We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.

Company Overview