Ensemble Health Partners

QA Engineer

• Auditing Patient Access calls, accounts, and work queues to ensure compliance and consistency to policy and procedure
• Identifying trends and providing reporting for training/coaching purposes to both leadership and associates
• Monitoring the quality audit tool and process and ensuring accurate record keeping and audit scoring and system documentation
• Partnering with the leadership team to monitor, record and provide individual performance reporting for training/coaching purposes
• Ensuring monthly quality scorecards are completed accurately and adhere to department standards and established metrics for quality
• Collaborating with Patient Access leadership to remain updated on any new policy and procedure changes

Quality Assurance Specialist

Analyst

Charge Description Master Analyst I

Project Manager

• Support Ensemble's growth through structured Standard Operating Model
• Coordinate across departments for successful outcomes
• Ensure project work is well-defined and planned
• Drive collaboration with Operations Readiness leaders
• Develop and maintain adherence to all SOP and processes
• Track and report portfolio performance and manage risks
• Support governance processes across departments

Senior Director, Project Management

Charge Description Master Analyst II

Events

• Performing in-depth analysis of claims, payments, and account reconciliations to ensure accuracy and compliance across the revenue cycle.
• Identifying trends in underpayments, denials, and revenue leakage.
• Evaluating root causes and recommending corrective actions to improve financial performance.
• Reviewing and validating claim and payment data.
• Interpreting contract reimbursement terms.
• Preparing detailed reports.
• Working assigned underpayment projects.
• Collaborating with cross-functional teams, escalating complex issues, and supporting continuous improvement initiatives to optimize processes and reduce cycle times.

Denials Prevention Revenue Cycle Analyst

Director

• Provide strategic oversight of coding operations, ensuring accuracy, productivity, and compliance with regulatory guidelines
• Monitor and improve coding KPIs, including quality, turnaround time, and audit performance
• Lead coding managers and teams, supporting performance management, development, and engagement
• Partner with Compliance, Revenue Integrity, and Clinical teams to ensure adherence to coding standards and regulatory requirements
• Design, build, and maintain Power BI dashboards to provide real-time visibility into coding performance, productivity, and trends
• Leverage Copilot and Power Platform tools (Power Apps, Power Automate, etc.) to streamline workflows and automate reporting
• Analyze trends in denials, audits, and coding performance to identify root causes and improvement opportunities
• Serve as a key liaison between Coding, IT, Analytics, Operations, and Client teams

Director, Coding

• Overseeing coding integration strategy, operations, and performance across a large, complex academic health system
• Ensuring seamless alignment between coding operations, clinical documentation, and enterprise revenue cycle performance
• Developing end-to-end coding integration strategy and execution across inpatient, outpatient, and professional services
• Ensuring alignment of coding workflows, processes, and systems across multiple facilities and care settings
• Standardizing policies, procedures, and best practices to drive consistency and efficiency across the enterprise
• Monitoring and optimizing coding KPIs including quality, productivity, turnaround time, and financial impact
• Analyzing trends in denials, audits, and coding outcomes to identify opportunities for improvement
• Serving as the primary escalation point for complex coding or client issues

Director, Client Coding Integrations

Counselor

• Perform benefit education and validation
• Face to face review of inpatient benefits
• Collect inpatient, observation, and outpatient liabilities
• Accurate verification and calculation of patient liabilities
• Perform functions while meeting Ensemble Health Partners' mission and regulatory compliance requirements
• Assess and collect patient liabilities including copays, deductibles, co-insurance and balances after financial assistance
• Utilize face to face communication with patients to collect estimated patient liability
• Make follow-up phone calls to patients that are unable to make payment while in-house

Financial Counselor

Billing Specialist

• Oversee all Ensemble Health Partners Billing associates
• Monitor associates time and attendance, productivity, QA reviews, daily assigned workflows
• Ensure associate education is provided, complete annual evaluations
• Monitor all associates supporting paper biller and electronic biller functions for accuracy
• Empower staff to develop methods of process improvement

Billing Supervisor

IT Support

• Interviews uninsured/under-insured patients to determine eligibility for a state Medicaid benefit or Financial Assistance program.
• Assists with application processes to facilitate accurate and appropriate submissions.
• Follows up on submitted applications to ensure timely billing or adjustment processing.
• Reviewing all referred uninsured/under-insured patients for program eligibility opportunities.
• Effectively communicating with the patient to obtain documents that must accompany the application.
• Following submitted applications to determination point, updating applicable insurance information and ensuring timely billing or adjustment posting.
• Documenting all relevant actions and communication steps in assigned patient accounting systems.
• Maintaining working knowledge of all state and federal program requirements; shares information with colleagues and supervisors.
• Developing and maintaining proactive working relationship with county/state/federal Medicaid caseworker partners, working collaboratively with other revenue cycle departments and associates.

Public Benefit Specialist

• Interviews uninsured/under-insured patients to determine eligibility for a state Medicaid benefit or location Financial Assistance program.
• Assists with application processes to facilitate accurate and appropriate submissions.
• Follows-up on submitted applications to insure timely billing or adjustment processing.
• Reviewing all referred uninsured/under-insured patients for program eligibility opportunities, initializing and coordinating the application process to facilitate accurate and appropriate submissions.
• Effectively communicating with the patient to obtain documents that must accompany the application.
• Following submitted applications to determination point, updating applicable insurance information and ensuring timely billing or adjustment posting.
• Documenting all relevant actions and communication steps in assigned patient accounting systems.
• Maintaining working knowledge of all state and federal program requirements; shares information with colleagues and supervisors.
• Developing and maintaining proactive working relationship with county/state/federal Medicaid caseworker partners, working collaboratively with other revenue cycle departments and associates.
• Other job duties as assigned.

• 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.
• Compile and analyze data to identify underpayments, and trends in the underpayments and report to leadership findings in a timely and consistent manner.
• Work collaboratively with other departments, including Managed Care, Billing, Coding, Revenue Integrity, and Payor Strategy.
• Work multiple projects, reports, and tasks efficiently in a fast-paced, KPI-driven atmosphere autonomously.

Revenue Recovery Associate Analyst I

Accounts Receivable

• Supervises the daily workflow of the department, monitoring progress to identify trends in denied payments by insurance companies, determining trends in unpaid claims and remediation solutions.
• Reviews Leadership No Touch Report if available to ensure all high dollar accounts are reviewed monthly.
• Reviews action logs daily and completed action logs pending to be verified.
• Conducts team huddles to efficiently cover new or evolving training focuses to encourage and develop team members, including sharing identified trends and solutions on unpaid and denied claims.
• Leads Team DIBS meetings and provides recap to team and leaders.
• Ensures adherence to the departmental budget, including overtime.
• Prepare monthly reports as requested.
• Establishes departmental goals with the staff to optimize performance and meet budgetary goals while improving operations to increase customer satisfaction and meet financial goals of the organization.
• Ensure all team members meet productivity and quality standards.
• Meets with all associates 1:1 monthly to review current performance.
• Maintains and communicates any associate behavior, performance and attendance issues that may constitute a verbal or a correction action and/or performance improvement plan.
• Ensures timely completion and documents conversations in Workday.
• Reviews assigned associate's time management and approve timecards for payroll processing in a timely manner.
• Reviews Roster in Workday to ensure correct client, cost center and work location assignment.
• Collects, interprets, and communicates performance data using various tools and systems, while also using this data to make decisions on how to achieve performance goals.
• Works with internal and external customers to make key decisions, impacting either the organization or an individual patient.
• Works closely with ancillary departments to establish and maintain positive relations to ensure revenue cycle goals are achieved.

Accounts Receivable Supervisor

Manager

• Responsible for planning, developing, organizing, and managing the Patient Access department
• Responsible for the performance and effectiveness of department(s)
• Coaching and development of all staff performing these functions
• Implementing short and long-term plans and objectives to improve customer service and collect quality information
• Provide leadership and contribute to the revenue cycle and organizational goals
• Work closely with the Director of Patient Access to align processes and procedures with Ensemble Health Partners policies

Patient Access Manager

Medical Billing and Coding

• Code claims directly from the medical record/operative report according to coding guidelines.
• Accurate and timely completion of work queues as assigned.
• Track and identify trends within charge review and follow up work queues and assist leadership in the resolution of those trends and/or educational needs.
• Assists with research of denied claims.
• Maintains compliance with established corporate and departmental policies and procedures, quality improvement program, customer service and productivity expectations.
• Must be able to achieve individual quality and productivity performance metrics in daily duties as set by coding leadership.
• Provide and/or assist with provider education, as well as the development of educational tools.
• Communicates professionally with physicians, management, and peers.
• Participates in all educational activities including coding meetings/calls necessary to provide information relating to coding and compliance.
• Remains abreast of changes to current payer guidelines, Correct Coding Initiative edits, and Local/National Coverage Determinations for accuracy in Coding and mentors team members regarding coding guidelines and accuracy.
• Assists with training of other coders.
• Takes initiative for learning new skills and willingness to participate and share expertise on projects, committees and other activities as deemed appropriate.
• Demonstrates personal responsibility for job performance.
• Extensive knowledge/experience in physician coding with expert knowledge in a specific coding specialty and the ability to provide education/support to coding team and providers.

Quality Assurance Specialist

Charge Description Master Analyst I

Senior Director, Project Management

Charge Description Master Analyst II

Denials Prevention Revenue Cycle Analyst

Director, Coding

Director, Client Coding Integrations

Financial Counselor

Billing Supervisor

Public Benefit Specialist

Public Benefit Specialist

Revenue Recovery Associate Analyst I

Accounts Receivable Supervisor

Patient Access Manager

Specialized Coder – Cardiology, Vascular, CVTS