Ensemble Health Partners is a technology-enabled revenue cycle management company serving health systems, hospitals, and affiliated physician groups.
The Denials Specialist is responsible for working clinically related claim denials across the organization. This role involves contacting insurance plans to determine why claims were denied, analyzing claims to decide whether an appeal is needed, preparing appeal materials, correcting and resubmitting claims when appropriate, gathering supporting medical records and documentation, and serving as a liaison between healthcare providers and payers. The position also requires timely submission of appeals and strong attention to quality and productivity standards.
Experience
- 1 to 3 years of related experience
- 2 years of denials or accounts receivable experience preferred
- Experience in hospital operations, chart audit/review, and provider relations
Education
- Associate's degree or equivalent experience
Skills
- Knowledge of revenue cycle terminology and processes
- Ability to analyze claims, remittances, and denial letters
- Ability to contact payers and identify root causes for denials
- Ability to prepare appeal materials and draft appeal letters accurately
- Strong typing skills; able to type 35 wpm
- Must be inquisitive and open to innovation, including the use of AI to improve processes
Additional Information
- Must be authorized to work in the United States
Perks and Benefits
- Bonus incentives
- Paid certifications
- Tuition reimbursement
- Comprehensive benefits
- Career advancement opportunities
- Associate benefits package including healthcare, time off, retirement, and well-being programs
- Quarterly and annual incentive programs
- Professional certification support
Location
Connecticut, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
Yes
Posted
3 weeks ago