Denials Specialist
Denials Specialist
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Job Description
Thank you for considering a career at Ensemble Health Partners!
Ensemble Health Partners is a leading provider of technologyenabled revenue cycle management solutions for health systems including hospitals and affiliated physician groups. They offer endtoend 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 $16.00 $22.35/hr based on experience
The Denials Specialist is responsible for clinically related claim denials across Ensemble Health Partners. Job duties include but are not limited to contacting insurance plans to determine reasons claims were denied analyzing the claims and determining if appeal is necessary preparing the appeal materials which may include correcting and resubmitting claims gathering additional information including reviews of medical records acting as a liaison between healthcare providers for any additional medical documentation or clarification and submitting appeals in a timely manner.
Essential Job Functions:
- Contacting insurance plans to determine reasons claims were denied
- Analyzing the claims and determining if appeal is necessary
- Preparing the appeal materials which may include correcting and resubmitting claims gathering additional information including reviews of medical records
- Acting as a liaison between healthcare providers for any additional medical documentation or clarification and submitting appeals in a timely manner
- Work closely with the Case Management Department and HIM Department to ensure denial trends and outcomes are communicated in a timely manner.
- Performs other duties as assigned
This document is not an exhaustive list of all responsibilities skills duties requirements or working conditions associated with the job. Associates may be required to perform other jobrelated duties as required by their supervisor subject to reasonable accommodation.
Job Experience:
- 1 to 3 Years
Education Level:
- Associates degree or Equivalent Experience
Knowledge Skills and Abilities:
- 2 Year/ associates degree 4 year/ bachelors degree
- Preferred Minimum Education Specialty/Major: Registered Nurse (RN) or relevant discipline
- Minimum Years and Type of Experience: 2 years of denials utilization review or case management experience strongly preferred
- Other Knowledge Skills and Abilities Required:
- Type 35 wpm
- Experience in hospital operations chart audit/review and provider relations
Join an awardwinning company
Fivetime winner of Best in KLAS 202025
Black Book Researchs Top Revenue Cycle Management Outsourcing Solution
22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle
Leader in Everest Groups RCM Operations PEAK Matrix Assessment 2024
Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance
Energage Top Workplaces USA
Fortune Media Best Workplaces in Healthcare 2024
Monster Top Workplace for Remote Work 2024
Great Place to Work certified
Innovation
WorkLife Flexibility
Leadership
Purpose Values
Bottom line we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:
- 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 wellbeing programs.
- Our Culture Ensemble is a place where associates can do their best work and be their best selves. We put people first last and always. Our culture is rooted in collaboration growth and innovation.
- 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.
Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race color sex sexual orientation gender gender identity religion national origin age disability military or veteran status genetic information or any other basis protected by applicable federal state or local laws. Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.
Ensemble Health Partners provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process please contact .
This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many jobrelated factors including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the roles range.
EEOC Know Your Rights
FMLA Rights English
Required Experience:
Unclear Seniority
Employment Type
Full-Time
