The Opportunity:

ENTRY LEVEL CAREER OPPORTUNITY OFFERING:

• Bonus Incentives
• Paid Certifications
• Tuition Reimbursement
• Comprehensive Benefits
• Career Advancement
• This position will pay between $66,300 - $99,450/annually based on experience.
  

By embodying our core purpose of customer obsession, new ideas, and driving innovation, and delivering excellence, you will help ensure that every touchpoint is meaningful and contributes to our mission of redefining the possible in healthcare.

The Sr Analyst, Revenue Recovery is a subject matter expert that is responsible for the maximation of insurance reimbursement by identifying contractual variances between posted payments and ethe 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 Analyst 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. Analyst will consistently review large amounts of remittance data to locate charge or billing opportunities for revenue optimization. The Sr Analyst will also assist leadership with initiatives, assist with client and payor escalations and be fully competent in all aspects of the EIQ Revenue Recovery prediction rules. The position will also complete assigned projects and serve as a mentor and subject matter expert to the team.

• 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.
• 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.
• Coordinate with leadership to guide client team and all Ensemble and team initiatives.
• Assist leadership in client and payor escalations to recovery underpayments quickly and efficiently.
• Have a keen understanding and experience with Ensemble IQ underpayment prediction rules and how they are utilized to identify underpayments.
• Participate in self-directed projects as assigned by leadership.
• Serve as a mentor and subject matter expert to other associates on the client team.

Ensemble Required License / Certification (Ex: CRCR) ONE CERTIFICATION PER FIELD

• CRCR - (Certified Revenue Cycle Representative) required within 9 months of hire

People Leadership Experience

• 5 to 7 Years

Preferred Area of Study

• High School Diploma, GED, or Equivalent Experience

Other Preferred Knowledge, Skills and Abilities

• Minimum of at least five (5) years of experience in the hospital or physician insurance industry, or elsewhere in the revenue cycle, required. Applicants must have a keen and proven understanding of the revenue cycle and the identification of underpaid accounts.
• Bachelors degree preferred, but not required. High school diploma or GED required.
• Excellent verbal and written communication skills.
• Profession presence.
• Exceptional customer service.
• Ability to adapt to multiple client host systems.
• Integrity and honesty.
• Internal drive to succeed.
• Experience with and ability to operate in Microsoft Office suite of programs.