Qureos Mentor

Ensemble Health Partners

<div><p><b>Thank you for considering a career at Ensemble!</b></p><p></p><p>
Ensemble 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.</p><p></p><p>
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!</p><p></p><p>
O.N.E Purpose:</p><ul><li><p><b>
Customer Obsession:</b> Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.</p></li><li><p><b>
Embracing New Ideas:</b> Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.</p></li><li><p><b>
Striving for Excellence:</b> Execute at a high level by demonstrating our &ldquo;Best in KLAS&rdquo; Ensemble Difference Principles and consistently delivering outstanding results.</p></li></ul><p></p><p><b>
The Opportunity:
</b></p><p></p><p><b>CAREER OPPORTUNITY OFFERING:</b></p><ul><li><p>
Bonus Incentives</p></li><li><p>
Paid Certifications</p></li><li><p>
Tuition Reimbursement</p></li><li><p>
Comprehensive Benefits</p></li><li><p>
Career Advancement</p></li><li><p>
This position pays between $29.70 - $31.80 based on experience</p></li></ul><p></p><p>
The Acute Coding Appeals Specialist integrates medical coding principles and objectivity in the performance of coding appeals activities. Draws on ICD10CM, ICD10PCS, HCPCS, NCCI, CMS and CMG coding expertise and industry knowledge to substantiate coding principles to determine potential billing/coding issues, and quality concerns. Under indirect supervision, the Coding Appeals Specialist is responsible for reviewing and writing appeals for inpatient Diagnosis Related Group, (DRG) denials in order to support the assigned DRG and to address the clinical documentation utilized in the decision-making process to support the validity of the assigned codes.</p><p></p><p><b>
Job Responsibilities:</b></p><ul><li><p>
The appeals professional integrates medical coding principles and objectivity in the performance of coding appeals/denials activities. Draws on ICD10CM, ICD10PCS, HCPCS, NCCI, CMS and CMG coding expertise and industry knowledge to substantiate coding principles to determine potential billing/coding issues, and quality concerns</p></li><li><p>
Participates in client system education to gain the knowledge necessary to appeal client accounts in ensuring that the coding is supported by the patient's clinical documentation, coding/cdi guidelines and other regulatory standards/guidelines as appropriate</p></li><li><p>
Maintain meticulous documentation, spreadsheets, account, and claim examples of root cause issues. Performs searches of governmental, payor-specific, hospital-specific, regulatory body, and literature rules, regulations, guidelines to identify and coding and billing requirements to make recommendations to client</p></li><li><p>
Assist in education and training for client coding companion as it relates to the outcomes of the coding appeals</p></li><li><p>
Meet established productivity standards for coding appeals &amp; coding certification requirement</p></li><li><p>
Attends in-house sessions to receive updated coding information and changes in coding and/or regulations</p></li><li><p>
Provides excellent customer service, in an organized and efficient manner, while maintaining a positive attitude</p></li></ul><p></p><p><b>
Required Experience:
</b></p><p></p><ul><li><p>Previous inpatient facility coding experience, working appeals, denials and edits</p></li><li><p>
5 years previous experience in coding, required</p></li><li><p>
Advanced knowledge of medical coding and billing systems, documentation, and regulatory requirements</p></li><li><p>
Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences.</p></li><li><p>
This is a remote position; however, candidates must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require.</p></li></ul><p></p><p><b>
Minimum Education:</b></p><p></p><ul><li><p>
High School Diploma or GED</p></li></ul><p></p><p><b>
Required Certification:</b></p><p></p><ul><li><p>
Active Coding Certification (i.e. RHIA, RHIT, CCS, CIC, CPC, COC, etc.)</p></li></ul><p><br>
#LI-HB1</p><p>
#LI-REMOTE</p><p></p><p><b>
Join an award-winning company</b></p><p></p><p>
Five-time winner of &ldquo;Best in KLAS&rdquo; 2020-2022, 2024-2025</p><p>
Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-2024</p><p>
22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024</p><p>
Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024</p><p>
Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023</p><p>
Energage Top Workplaces USA 2022-2024</p><p>
Fortune Media Best Workplaces in Healthcare 2024</p><p>
Monster Top Workplace for Remote Work 2024</p><p>
Great Place to Work certified 2023-2024</p><ul><li><p>
Innovation</p></li><li><p>
Work-Life Flexibility</p></li><li><p>
Leadership</p></li><li><p>
Purpose + Values</p></li></ul><p></p><p>
Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:</p><ul><li><p><b>
Associate Benefits &ndash; </b>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.</p></li><li><p><b>
Our Culture</b> &ndash; 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.
</p></li><li><p><b>Growth &ndash; </b>We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.</p></li><li><p><b>
Recognition &ndash; </b>We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.</p></li></ul><p></p><p>
Ensemble 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 also prohibits harassment of applicants or employees based on any of these protected categories.</p><p></p><p>
Ensemble 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.</p><p></p><p>
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&rsquo;s range.</p><p></p><p>
Employment Disclaimers &ndash; Ensemble</p></div>

Acute Coding Appeals Specialist

<div><div>Thank you for considering a career at Ensemble Health Partners!</div><div></div><div>
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.</div><div></div><div>
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!</div><div></div><div>
O.N.E Purpose:</div><ul><li><div>
Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.</div></li><li><div>
Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.</div></li><li><div>
Striving for Excellence: Execute at a high level by demonstrating our &ldquo;Best in KLAS&rdquo; Ensemble Difference Principles and consistently delivering outstanding results.</div></li></ul><div></div><div>
The Opportunity:</div><div></div><div>
ENTRY LEVEL CAREER OPPORTUNITY OFFERING:</div><ul><li>
Bonus Incentives</li><li>
Paid Certifications</li><li>
Tuition Reimbursement</li><li>
Comprehensive Benefits</li><li>
Career Advancement</li><li>
This position pays between $17.00 - $18.15/Hour based on experience</li></ul><div><br>
***This position is an onsite role, and candidates must be able to work on-site at HSHS - St. Nicholas Hospital in Sheboygan, WI. ***</div><div></div><div>
We are searching for the next Patient Access Specialist champion. This role is responsible for performing admitting duties for all patients admitted for services at the hospital. They are responsible for performing these functions while meeting the mission and goals of the organization and all regulatory compliance requirements. The Representative will work within the policies and processes as they are being performed across the entire organization.</div><div></div><div>
Job Responsibilities:</div><ul><li>
Patient Access staff are responsible for assigning accurate MRNs, completing medical necessity / compliance checks, providing proper patient instructions, collecting insurance information, receiving, and processing physician orders, and utilizing an overlay tool while providing excellent customer service as measured by Press Ganey.</li><li>
Operates the telephone switchboard to relay incoming, outgoing, and inter-office calls as applicable.</li><li>
They are to adhere to policies and provide excellent customer service in these interactions with the appropriate level of compassion.</li><li>
Patient Access staff will be held accountable for point of service goals as assigned.</li><li>
Patient Access staff are responsible for the utilization of quality auditing and reporting systems to ensure accounts are corrected. These activities may include accounts for other employees, departments, and facilities. Conducts audits of accounts and assures that all forms are completed accurate, timely to meet audit standards and provides statistical data to Patient Access leadership.</li><li>
Patient Access Staff are responsible for the pre-registration of patient accounts prior to patient visits. This may include inbound and outbound calling to obtain demographic, insurance, and other patient information including the patient financial liabilities including collecting point of service collections as well as past due balances including payment plan options.</li><li>
The Patient Access Staff explains general consent for treatment forms to the patient/guarantor/legal guardian, obtains necessary signatures and witness&rsquo;s name. Explains and distributes patient education documents, such as Important Message from Medicare, Important Message from Tricare, Observation Forms, MOON form, Consent forms, and all forms implemented for future services.</li><li>
Reviews eligibility responses in insurance verification system and appropriately selects the applicable insurance plan code, enters benefit data into system to support POS (Point of Service Collections) and billing processes to assist with a clean claim rate.</li><li>
Responsible for accurately screening of medical necessity using the Advanced Beneficiary Notice (ABN) software to inform Medicare patients of possible non-payment of test by Medicare and distribution of the ABN as appropriate. Responsible for distribution and documentation of other designated forms and pamphlets.</li></ul><div></div><div>
Experience We Love:</div><ul><li>
1+ years of customer service experience</li></ul><div><br>
Minimum Education:</div><ul><li>
High School Diploma/GED Required</li></ul><div></div><div>
Certifications:</div><ul><li>
HFMA Certified Revenue Cycle Representative (CRCR) within 9 months of hire</li></ul><div></div><div>
#LI-LL1</div><div></div><div>
Join an award-winning company</div><div></div><div>
Five-time winner of &ldquo;Best in KLAS&rdquo; 2020-2022, 2024-2025</div><div>
Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-2024</div><div>
22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024</div><div>
Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024</div><div>
Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023</div><div>
Energage Top Workplaces USA 2022-2024</div><div>
Fortune Media Best Workplaces in Healthcare 2024</div><div>
Monster Top Workplace for Remote Work 2024</div><div>
Great Place to Work certified 2023-2024</div><ul><li><div>
Innovation</div></li><li><div>
Work-Life Flexibility</div></li><li><div>
Leadership</div></li><li><div>
Purpose + Values</div></li></ul><div></div><div>
Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:</div><ul><li>
Associate Benefits &ndash; 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.</li><li><div>
Our Culture &ndash; 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.</div></li><li><div>
Growth &ndash; We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.</div></li><li><div>
Recognition &ndash; We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.</div></li></ul><div></div><div>
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.</div><div></div><div>
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 <div>TA@ensemblehp.com</div>.</div><div></div><div>
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&rsquo;s range.</div><div></div><div><div>
EEOC &ndash; Know Your Rights</div><br>
<div>FMLA Rights - English</div></div><div><div>
La FMLA Espa&ntilde;ol</div></div><div><div>
E-Verify Participating Employer</div> (English and Spanish)</div><div><div>
Know your Rights</div></div></div>

Patient Access Associate Specialist - Full Time

Join Ensemble Health Partners and explore 2   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Ensemble Health Partners

About Company

Acute Coding Appeals Specialist

Patient Access Associate Specialist - Full Time