Communicate directly with payors to follow up on outstanding underpayments, file underpayment appeals with payors, resolve account variance and ensure timely and accurate recovery of underpayments.
Identify root cause of underpayments, denials, and delayed payments to clients.
Work with the client team to identify, document, and address root causes of issues in the A/R.
Maintain a thorough understanding of applicable state and federal insurance regulations as well as payor specific requirements, taking actions on underpayments accordingly.
Document all activity accurately with all pertinent information in the client’s host system, Ensemble IQ, or other appropriate tracking system.
Demonstrate initiative and resourcefulness by making recommendations and communicating trends and issues to management.
Operate as a strong problem solver and critical thinker to resolve underpayments.
Meet all productivity and quality standards as established by Ensemble and Revenue Recovery leadership.
Compile and analyze data to identify underpayments, and trends in the underpayments and report to leadership findings in a timely and consistent manner.
Work collaboratively with other departments, including Managed Care, Billing, Coding, Revenue Integrity, and Payor Strategy.
Work multiple projects, reports, and tasks efficiently in a fast-paced, KPI-driven, atmosphere autonomously.

Minimum five (5) years of experience in the hospital or physician insurance industry, or elsewhere in the revenue cycle, required.
Applicants must have a keen and proven understanding of the revenue cycle and the identification of underpaid accounts.
Excellent verbal and written communication skills.
Professional presence.
Exceptional customer service.
Ability to adapt to multiple client host systems.
Integrity and honesty.
Internal drive to succeed.
Experience with and ability to operate in Microsoft Office suite of programs.
Desired Education: Bachelor's degree preferred, but not required. High school diploma or GED required.

Revenue Recovery Analyst I

Key skills