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Accounts Receivable Specialist
Accounts Receivable SpecialistEnsemble Health Partners • Riverside, CA, US
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Accounts Receivable Specialist

Accounts Receivable Specialist

Ensemble Health Partners • Riverside, CA, US
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Accounts Receivable Specialist

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 :

  • Bonus Incentives
  • Paid Certifications
  • Tuition Reimbursement
  • Comprehensive Benefits
  • Career Advancement
  • This position pays between $16.50 - $18.15 / hr based on experience

Accounts Receivable Specialist is responsible for following up directly with commercial, governmental, and other payers to resolve claim payment issues, to secure appropriate and timely reimbursement and response. Identifies and analyzes denials, payment variances, and no response claims and acts to resolve claims / accounts, including drafting and submitting technical and clinical appeals. Provides support for all denial, no response, and audit activities.

Essential Job Duties :

  • Examines denied and other non-paid claims to determine the reason for discrepancies.
  • Communicates directly with payers to follow up on outstanding claims, files technical and clinical appeals, resolves payment variances, and ensures timely and accurate reimbursement.
  • Ability to identify specific reasons for 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 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.
  • Needs to be a strong problem solver and critical thinker to resolve accounts.
  • Expected Knowledge, Skills and Abilities :

  • Must demonstrate basic computer knowledge and demonstrate proficiency in Microsoft Excel.
  • Excellent Verbal skills.
  • Problem solving skills, the ability to look at accounts 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.
  • Preferred Knowledge, Skills, and Abilities :

  • 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.
  • Experience working the DDE Medicare system and using payer websites to investigate claim statuses.
  • Working knowledge of medical terminology and / or insurance claim terminology.
  • Join an award-winning company :

  • Five-time winner of "Best in KLAS" 2020-2022, 2024-2025
  • Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-2024
  • 22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024
  • Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024
  • Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023
  • Energage Top Workplaces USA 2022-2024
  • Fortune Media Best Workplaces in Healthcare 2024
  • Monster Top Workplace for Remote Work 2024
  • Great Place to Work certified 2023-2024
  • Innovation, Work-Life 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 well-being 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 TA@ensemblehp.com.

    This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related 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 role's range.

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    Account Receivable Specialist • Riverside, CA, US

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