Revenue Recovery Associate Analyst I

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 $45,000.00 - $81,750.00/ based on experience and other factors.

The Analyst I is a subject matter expert that is responsible for the maximation 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 requi