Senior Quality Specialist at Ensemble Health Partners

, Ohio, United States -

Full Time

Start Date

Immediate

Expiry Date

20 Jun, 26

Salary

18.65

Posted On

22 Mar, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Quality Assurance, Account Reviews, Revenue Cycle Management, Accounts Receivable, Epic Payment System, Training, Onboarding Support, Quality Audit, Compliance, Risk Mitigation, Reporting, Process Improvement, Innovation, AI, Medical Necessity, Clinical Documentation

Industry

Hospitals and Health Care

Description

Thank you for considering a career at Ensemble! 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. 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! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation. Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results. The Opportunity: CAREER OPPORTUNITY OFFERING Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement The pay starts at $18.65 for the Senior Quality Specialist. Final pay will be determined based upon experience and equity. The Quality Specialist will play an essential role in reviewing and ensuring the quality of the Revenue Cycle teams’ work efforts. The primary responsibility of this role is to perform independent account reviews that have been worked by our Revenue Cycle team members with the purpose of identifying opportunity and making recommendations for improvement to the operational and executive leaders. Essential Job Functions: This role will assist Leadership with continued training, education and ongoing action plans to ensure quality is consistently met for existing teams in partnership with the Sr Quality Specialist and Leadership Team. In addition, this role will assist the Sr Quality Specialist and Leadership Team with onboarding support including user provisioning as required. Assesses the Quality Assurance process and actively looks for opportunities to increase efficiency and proactively brings to Leadership attention. Evaluate operational and management Quality Audit policies/procedures and provide input into the annual review workplan. Performs Quality reviews across multiple clients, working in a variety of host systems. Coordinate with service line leaders and partner with upper-level Leadership, to identify areas of risk and assist leadership in developing a quarterly/ annual review plan. Develop a thorough understanding of business processes in scope for assigned reviews and document the processes. Perform account level review to ensure consistency with best practices including but not limited to Quality Audit to confirm implementation and effectiveness of policies/procedures. Perform reviews to measure compliance with policies, procedures, workflow, and other applicable requirements. Identify and document operational, compliance, and quality risks and make recommendations to mitigate risks. Prepare and assist in presenting quality reports of review findings and recommendations to direct leadership for review and approval. Participate in pre- & post-review meetings, providing support and recommendations for issues presented. Ensure past review recommendations are implemented in current review process. Maintain current knowledge of laws/regulations regarding medical necessity, clinical documentation, compliance standards, other general clinical and/or business matters related to the service line they are working. Required Job Experience: 5 to 7 Years experience in Quality Assurance At least 3 years Accounts Receivable experience Epic Payment system experience Revenue Cycle Management experience Experience We Love: 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. 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. Required Education Level: Associates Degree or Equivalent Experience Required Certifications: CRCR, either upon hire or within 9 months of hire. Join an award-winning company Five-time winner of “Best in KLAS” 2020-2022, 2024-2025 Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-2024 22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024 Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024 Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023 Energage Top Workplaces USA 2022-2024 Fortune Media Best Workplaces in Healthcare 2024 Monster Top Workplace for Remote Work 2024 Great Place to Work certified 2023-2024 Innovation Work-Life Flexibility Leadership Purpose + Values Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include: Associate Benefits – 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. Our Culture – 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. Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement. Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company. 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. 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. 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’s range. EEOC – Know Your Rights FMLA Rights - English La FMLA Español E-Verify Participating Employer (English and Spanish) Know your Rights Legitimate Ensemble Recruiters will only contact you from an email address ending in “@ensemblehp.com.” Don’t fall victim to fake job postings from fraudsters posing as Ensemble Human Resources personnel. Ensemble will never ask for a payment in exchange for a job opportunity or ask you to submit sensitive personal information via email, phone, form, app or text. Ensemble is dedicated to providing our clients with experienced healthcare finance and revenue cycle professionals. We believe that our core values of trust, integrity, loyalty and service married with the belief that our work is worthwhile helps us build and sustain sincere relationships with our associates and clients. If you are a passionate, dedicated and experienced revenue cycle, consulting or finance professional and seek career and personal growth, we would love to hear from you. We believe we foster an environment where talented individuals can excel and shine. Our team believes that people are the most important part of our success and that when we take care of our people, they pay it forward by providing our clients with excellent results and world-class service.

Responsibilities

The Quality Specialist will independently review accounts worked by Revenue Cycle team members to identify opportunities and recommend improvements to operational and executive leaders. This role also assists leadership with continued training, education, action plans, and onboarding support to ensure consistent quality.