Ensemble Health Partners

Senior Specialist, Accounts Receivable

Ensemble Health Partners

full-time

Posted on:

Location Type: Remote

Location: United States

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Salary

💰 $19 per hour

Job Level

Senior

About the role

  • Mentors AR Specialist team members to help develop and improve their skills in the denials and appeals process.
  • Examines denied and other non-paid claims to determine reason for discrepancies.
  • Demonstrates initiative in resolving complex claims and proactively makes recommendations to management on specific trends or necessary interventions.
  • Communicates directly with payers to follow up on outstanding claims, files technical and clinical appeals, resolves payment variances, and ensures timely and accurate reimbursement.
  • Provides guidance to other team members on resolving complex claims and filing appeals.
  • Ability to identify with specific reason underpayments, denials, and cause of payment delay.
  • Works with management to identify, trend, and address root causes of issues in the A/R.
  • Takes meeting minutes for payor escalation calls and provides feedback to the AR associates key takeaways from the calls.
  • 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.
  • Reviews escalations from other areas to AR as well as accounts that require escalation to other areas of Revenue Cycle.
  • Assists the supervisor with DIBS calls as needed.
  • Needs to be a strong problem solver and critical thinker to resolve accounts.
  • Must meet productivity and quality standards as established by Ensemble.

Requirements

  • 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.
  • Must demonstrate basic computer knowledge and demonstrate proficiency in Microsoft Excel.
  • Internal candidate must have met 120% Productivity and 98% Quality Assurance in each of the previous 3 months.
  • External candidates must meet quality and productivity standards by day 90.
  • Excellent verbal skills.
  • Problem solving skills, the ability to look at account 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.
Benefits
  • Bonus Incentives
  • Paid Certifications
  • Tuition Reimbursement
  • Comprehensive Benefits
  • Career Advancement
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
medical collectionsdenials and appealsAR follow-upcomplianceprovider relationsprofessional billingMicrosoft Excelproblem solvingcritical thinkingproductivity standards
Soft Skills
mentoringcommunicationinitiativeresourcefulnessadaptabilityteamworkattention to detailtime managementfeedback provisionanalytical thinking
Certifications
2 or 4-year college degree