Ensemble Health Partners · 9 hours ago
Sr Specialist, Accounts Receivable
United States
Full-time
Remote
Mid, Senior Level
$18.15/hr - $18.15/hr
1+ years expEnsemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems. The Senior Accounts Receivable Specialist is responsible for follow-up and denial activities, working directly with payers to resolve claim payment issues and mentoring team members in the process.
Health CareHospitality
Responsibilities
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
Performs other duties as assigned, including projects
Qualification
Required
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
Performs other duties as assigned, including projects
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. Failure to meet this standard will result in demotion to AR Specialist and will become eligible to re-apply for Sr AR Specialist 90 days following the demotion
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
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
Knowledge of claims review and analysis
Working knowledge of revenue cycle. CRCR, either upon hire or within 9 months of hire
Experience working the DDE Medicare system and using payer websites to investigate claim statuses
Working knowledge of medical terminology and/or insurance claim terminology
Benefits
Bonus Incentives
Paid Certifications
Tuition Reimbursement
Comprehensive Benefits
Career Advancement
Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.
Company
Ensemble Health Partners
Ensemble Health Partners is the leading revenue cycle management company for hospitals, health systems and physician practices.
10001+ employees
Funding
Current Stage
Late StageTotal Funding
unknown2022-03-25Private Equity
2019-05-30Acquired
Leadership Team
Judson Ivy
Founder and CEO
Matt Tormey
EVP Compliance and Risk
Recent News
2025-12-10
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