Ensemble RCM LLC is seeking a Denials Specialist to support clinically related claim denials across its healthcare revenue cycle operations.
This role is responsible for analyzing denied claims, contacting insurance plans to determine denial reasons, deciding whether an appeal is warranted, and preparing appeal materials. The position also involves correcting and resubmitting claims when appropriate, gathering supporting documentation such as medical records, and serving as a liaison between healthcare providers and payers to obtain additional information or clarification.
The position offers an opportunity to work with a leading healthcare revenue cycle organization that supports hospitals and physician groups nationwide.
Qualifications
- 1 to 3 years of experience
- Associate degree or equivalent experience
- 2 years of experience in denials or accounts receivable
- Experience with hospital operations, chart audit/review, and provider relations
- Ability to type 35 words per minute
- Strong knowledge of revenue cycle terminology and processes
- Ability to triage denials and determine appropriate next steps
- Strong written communication skills for drafting appeal letters
- Inquisitive mindset and openness to innovation, including AI-enabled process improvement
Benefits and Perks
- Bonus incentives
- Paid certifications
- Tuition reimbursement
- Comprehensive benefits
- Career advancement opportunities
- Quarterly and annual incentive programs
- Healthcare, time off, retirement, and well-being programs
- Work-life flexibility
- Professional development support
Location
Ohio, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
1 week ago