Audit & Appeals Analyst Jobs

Thank you for considering a career at Ensemble Health Partners!
Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end 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
The Opportunity:
Analyzes hospital claims to identify contractual underpayments or billing errors on coding audit/appeal accounts.
Examines denied and underpaid claims to determine reason for discrepancies.
Resolves underpaid claims from various payer products including HMO, PPO, Medicaid, Medicare and Workers' Compensation. Articulates contract provisions to representatives from healthcare payer companies and government agencies. Contacts payer companies via phone or correspondence and initiates request for payment.
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
Maintains a thorough understanding of federal and state regulations, as well as payer specific requirements and taken appropriate action accordingly.
Documents activity accurately including contact names, addresses, phone numbers, and other pertinent information
Demonstrates initiative and resourcefulness by making recommendations and communicating trends and issues to management.
Needs to be a strong problem solver and critical thinker to resolve accounts.
Must meet productivity and quality standards.
Serves as a subject matter expert in Payer contract dispute resolution process.
Established and productive professional individual contributor
Works independently with general supervision
Problems faced are difficult but typically not complex
May influence others within the job area through explanation of facts, policies and practices
Works to achieve operational targets within job area with direct impact on department results. Works independently on larger, moderately complex projects/ assignments.
Sets objectives for own job area to meet the objectives or goals of projects and assignments.
Responsible for making adjustments or recommended enhancements in systems and processes to solve problems or improve effectiveness of job area.
Join An Award-winning Company
Three-time winner of “Best in KLAS” 2020-2022
2022 Top Workplaces Healthcare Industry Award
2022 Top Workplaces USA Award
2022 Top Workplaces Culture Excellence Awards

• Purpose + Values
• Innovation
• Work-Life Flexibility
• Leadership

Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:

• Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
• 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.
• Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.
• 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.

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 [email protected].
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