Accounts Receivable Specialist

🔥 21 hours ago

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Ensemble Health Partners

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

⚕️ Healthcare Insurance

☁️ SaaS

🏢 Enterprise

💰 Private Equity Round on 2022-03

Healthcare Insurance • SaaS • Enterprise

Ensemble Health Partners is a leading provider of revenue cycle management (RCM) services for healthcare organizations. They offer an end-to-end RCM solution that helps hospitals, health systems, and affiliated physician groups optimize their revenue cycles, reduce denials and underpayments, and enhance patient experiences using a combination of expert management and advanced technology. Ensemble Health Partners leverages certified operators and AI to deliver consistent results, improve collections, and support future growth for healthcare providers. They are recognized for their robust client partnerships and commitment to delivering reliable revenue lift and cost savings for their clients.

📋 Description

• Accounts Receivable Specialist is responsible for following up directly with commercial, governmental, and other payers to resolve claim payment issues, to secure appropriate and timely reimbursement and response. • Identifies and analyzes denials, payment variances, and no response claims and acts to resolve claims/accounts, including drafting and submitting technical and clinical appeals. • Provides support for all denial, no response, and audit activities. • 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.

🎯 Requirements

• 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. • 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.

🏖️ Benefits

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