Senior Analyst, Revenue Recovery

This is a fully remote position, open to applicants in Ohio.

📋 Description

• Optimize insurance reimbursements by identifying discrepancies between actual payments and anticipated reimbursements.

• Evaluate contractual reimbursements and relay payment inconsistencies to both internal and external teams.

• Spot patterns in underpayments and devise effective resolutions.

• Analyze extensive remittance data to uncover billing opportunities that enhance revenue.

• Engage directly with payors regarding unresolved underpayments.

• Submit appeals for underpayments and rectify account discrepancies.

• Determine root causes of underpayments, denials, and delays in payments.

• Record activities in client host systems, Ensemble IQ, or other tracking platforms.

• Gather and assess data, reporting findings and trends to leadership.

• Collaborate with Managed Care, Billing, Coding, Revenue Integrity, and Payor Strategy teams.

• Support client and payor escalations.

• Utilize Ensemble IQ underpayment prediction rules to detect underpayments.

• Complete designated projects and self-directed initiatives.

• Guide associates and act as a subject matter expert.

• Achieve productivity and quality benchmarks.

⛳️ Requirements

• CRCR (Certified Revenue Cycle Representative) must be obtained within 9 months of hire.

• 5 to 7 years of experience in leadership roles.

• At least five (5) years of experience in the hospital or physician insurance sector, or within the revenue cycle.

• Strong and demonstrated understanding of the revenue cycle and the identification of underpaid accounts.

• High school diploma or GED is required.

• Exceptional verbal and written communication abilities.

• Outstanding customer service skills.

• Capability to adapt to various client host systems.

• Proficiency in operating within the Microsoft Office suite.

• Ability to remain informed about relevant state and federal insurance regulations and payor-specific requirements.

• Bachelor’s degree is preferred, though not mandatory.

🏝️ Benefits

• Bonus incentives.

• Paid certifications.

• Tuition reimbursement.

• Comprehensive benefits package including healthcare, time off, retirement, and well-being programs.

• Professional certification relevant to the associate’s field.

• Flexibility in work-life balance.

• Quarterly and annual incentive programs.

• Opportunities for career advancement.

• Professional development and growth opportunities.