Ensemble Health Partners

Product Manager

• Lead the continued expansion of assigned Ensemble IQ workflow products within the back end of revenue cycle
• Engage with cross-functional matrix partners to define business requirements based on valued outcomes
• Document product definitions, including roadmaps, scope, feature definitions, business models, and workflows
• Engage directly with delivery teams to ensure a holistic, value-focused approach in an Agile framework
• Collaborate with revenue cycle operations and apply market research to develop requirements supporting product strategy and roadmaps
• Gather and document user requirements and develop business cases covering revenue yield and productivity cost savings
• Contribute to funding and approval requests for the IT steering committee
• Collaborate with engineering to deliver prioritized features in Agile and DevOps frameworks
• Create, maintain, and communicate prioritized product and team backlogs
• Contribute to marketing collateral and product demonstrations
• Coordinate deliverables with global teams

Senior Product Manager

Supervisor

• Supervise virtual utilization review activities supporting financial, quality, and clinical performance
• Facilitate medical record documentation improvement and completeness
• Utilize proactive triggers to identify potential over- or under-utilization of services
• Refer cases to the physician advisor and identify barriers to patient progress
• Conduct daily medical necessity reviews for admissions, patient status, and continued stays
• Perform inpatient and observation clinical reviews for commercial carriers within one business day of admission
• Communicate review outcomes and collaborate with hospital liaisons on documentation, education, and level-of-care opportunities
• Coordinate denial appeals, maintain appeal documentation, monitor denial trends, and report readmissions
• Collaborate with healthcare teams to achieve outcomes management goals, including CMS indicators
• Maintain case management work queues and accurately record and submit statistical data
• Facilitate multidisciplinary patient care plans and continuity of care
• Communicate benefit non-coverage issues and educate hospital and medical staff
• Participate in process improvement teams, departmental meetings, conferences, committees, and task forces
• Provide backup support to departmental staff and comply with hospital, department, confidentiality, and patient-rights policies

Utilization Review Supervisor

Patient Access Specialist

• Perform admitting duties for all patients admitted for hospital services
• Assign accurate MRNs
• Complete medical necessity and compliance checks
• Provide patient instructions and excellent customer service
• Collect insurance information and process physician orders
• Operate the telephone switchboard
• Meet assigned point-of-service goals
• Use quality auditing and reporting systems to correct accounts
• Conduct account audits and provide statistical data to Patient Access leadership
• Pre-register patient accounts before visits
• Obtain demographic, insurance, and financial liability information through inbound and outbound calls
• Collect point-of-service collections and past-due balances, including payment plan options
• Explain consent forms and obtain necessary signatures and witness names
• Distribute patient education documents and designated forms
• Review insurance eligibility responses and enter benefit data to support collections and billing
• Screen medical necessity using ABN software and distribute/document required forms

Accounts Receivable

• Perform follow-up and denial activities
• Follow up directly with commercial, governmental, and other payers to resolve claim payment issues and secure timely reimbursement
• Identify trends in denied payments and changes in insurance company policies
• Communicate with other departments to resolve denial issues
• Submit technical and clinical appeals
• Mentor AR Specialist team members and provide guidance on complex claims and appeals
• Examine denied and non-paid claims to determine discrepancies
• Resolve complex claims and recommend interventions to management
• Follow up on clean claim delays and document issues in escalation spreadsheets
• Identify, trend, and address root causes of underpayments, denials, and payment delays
• Take meeting minutes for payer escalation calls and communicate key takeaways
• Maintain understanding of federal and state regulations and payer requirements
• Accurately document claim activity in client host and tracking systems
• Review and manage escalations within the revenue cycle
• Assist leadership with AR reduction, cash acceleration projects, and DIBS calls
• Meet productivity and quality standards
• Perform other assigned duties and projects

Senior Accounts Receivable Specialist

Project Manager

• Perform project management functions aligned with PMO best practices for technology, client, vendor, and strategic projects
• Lead project teams through initiation, planning, execution/monitoring and controlling, and closing
• Define project scope, estimate costs, budget, resource, schedule, and maintain change control
• Manage risks, issues, actions, and changes, including timely decision-making and issue resolution
• Establish and execute communications plans for stakeholders
• Clarify objectives, scope, and roles and provide regular status and performance reports
• Monitor and manage project cost and team performance
• Manage changes to project scope, schedule, and costs using appropriate verification techniques
• Measure project performance using appropriate tools and techniques
• Adhere to enterprise PMO best practices and tools
• Implement projects for new and existing clients, focusing on on-time, on-budget, high-quality vendor installations

Financial Planning and Analysis

• Lead annual budget and quarterly forecast creation
• Collaborate with business leaders on revenue and expense estimates
• Create pro forma financial models forecasting business performance and financial results
• Mentor, coach, and develop a team of 2 to 4 analysts
• Manage Workday Adaptive Planning models and identify automation opportunities
• Track and review actuals versus budget and forecast estimates
• Deliver financial variance commentary explaining performance drivers and root causes
• Advise on ROI and financial decisions for initiatives, clients, and business opportunities
• Prepare executive and Board presentations and investor materials
• Assist with capital planning, scenario planning, and M&A
• Define and monitor KPIs with Strategy and Analytics teams
• Partner with Accounting on month-end close and audit support
• Analyze strategic problems and data to provide financial insights and recommendations
• Document work processes, data sources, and definitions
• Work independently and handle non-routine situations
• Report to the AVP of FP&A
• Travel quarterly

Manager, Financial Planning & Analysis

• Perform admitting duties for patients receiving hospital services
• Assign accurate medical record numbers (MRNs)
• Complete medical necessity and compliance checks
• Provide patient instructions and collect insurance information
• Receive and process physician orders
• Operate the telephone switchboard
• Provide compassionate customer service
• Meet assigned point-of-service goals
• Use quality auditing and reporting systems to correct accounts
• Conduct account audits and provide statistical data to Patient Access leadership
• Pre-register patient accounts before visits
• Make inbound and outbound calls to obtain demographic, insurance, and financial information
• Collect point-of-service payments and past-due balances, including payment plan options
• Explain consent and patient education forms and obtain required signatures
• Review insurance eligibility and select applicable insurance plan codes
• Enter benefit data to support collections and billing and clean claim rates
• Screen medical necessity using ABN software and distribute required notices and forms

Patient Access

• Oversee daily operations of the patient access/pre-access team
• Coordinate registration and pre-registration duties
• Provide staff training, coaching, education, and performance feedback
• Monitor productivity and department KPIs, including point of service, wait times, overtime, and productivity
• Prepare and review performance reports on daily, weekly, monthly, quarterly, annual, or as-needed schedules
• Assign and coordinate staff schedules, rotations, time off, and call-offs
• Track and monitor upfront collection processes; assign goals and provide corrective action
• Participate in an on-call rotation covering days, nights, and weekends
• Provide administrative and educational guidance during on-call duties and fill in for staffing issues or unexpected volumes
• Develop department processes and procedures; conduct audits and continuous coaching
• Act as a resource for staff and ancillary departments while promoting customer service standards
• Manage assigned implementation, tracking, and process-change projects
• Report routinely to Patient Access Leadership
• Participate in facility activities and gather statistical information
• Assist with staff evaluations and maintain the time/attendance system
• Attend facility meetings to ensure process alignment and effective communication
• Partner with clients to optimize front-end processes and improve patient satisfaction and operational efficiency

Patient Access & Pre-Access Supervisor

Medical writer

• Oversee Clinical Documentation Integrity operations supporting medical staff bylaws and regulatory requirements for clinical documentation and DRG assurance
• Maintain strong physician engagement
• Develop and monitor site departmental goals and objectives
• Support performance improvement processes in conjunction with revenue cycle
• Develop clinical data reporting and analyze, manipulate, and articulate data outcomes to improve operations
• Maintain knowledge of coding guidelines and regulations and communicate with market CDI leaders and associates
• Validate CDI quality assurance measures for accurate metrics and reimbursement reporting
• Generate and analyze data and reports to identify clinical documentation improvement opportunities
• Provide feedback to site CDI leaders and administrators and develop and implement action plans
• Establish and monitor team workflows, productivity, and quality assurance
• Evaluate associate and team performance and organizational requirements
• Chair market-level Steering Committees and Documentation Improvement meetings and reporting
• Meet with site and regional Physician Documentation Improvement designees
• Assist with department policies and standard operating procedures while providing supervisor support and guidance
• Collaborate with physicians, nurse practitioners, PAs, site administrators, department leaders, CDI, Coding, and Revenue Cycle Leadership on documentation initiatives, standardization, operational improvement, strategic growth, and education

Clinical Documentation Manager

Auditor

• Lead audits of complex cases and high-risk claims
• Review escalated audit findings and provide expert guidance
• Mentor and train junior nursing auditors
• Collaborate with compliance and revenue cycle leadership on audit strategies
• Prepare comprehensive reports and present findings to senior management
• Identify trends and recommend process improvements to reduce risk
• Enhance revenue cycle performance by identifying systemic issues and recommending improvements
• Ensure compliance with clinical and financial standards

Senior Auditor, Nursing

• Perform admitting duties for all patients admitted for hospital services
• Assign accurate MRNs
• Complete medical necessity and compliance checks
• Provide patient instructions and collect insurance information
• Receive and process physician orders
• Use overlay tools while delivering excellent customer service
• Operate the telephone switchboard
• Meet assigned point-of-service goals
• Use quality auditing and reporting systems to correct accounts
• Conduct account audits and provide statistical data to Patient Access leadership
• Pre-register patient accounts before visits
• Make inbound and outbound calls to obtain demographic, insurance, and financial-liability information
• Collect point-of-service payments and past-due balances, including payment-plan options
• Explain consent and patient-education forms, obtain signatures, and distribute required documents
• Review insurance eligibility responses and select insurance plan codes
• Enter benefit data to support point-of-service collections and billing processes
• Screen medical necessity using ABN software and distribute/document applicable forms

Patient Access Associate Specialist

Director

• Build strong, trusted client relationships and serve as a strategic partner
• Develop a deep understanding of client KPIs and SLAs within the first 60 days
• Identify and execute opportunities to improve performance, satisfaction, and outcomes
• Oversee complex multi-client utilization review and utilization management operations
• Drive measurable improvements in performance, productivity, and SLA attainment
• Lead data-driven decision-making using dashboards and analytics tools
• Champion adoption of new technologies and investment capabilities
• Lead large-scale change initiatives across people, process, and technology
• Partner cross-functionally to implement process and system improvements
• Lead, develop, and mentor a global, multi-layered team of 125–175 employees
• Manage and empower at least 3 direct-report leaders
• Foster a high-performing culture aligned with organizational values
• Travel up to 25% as required

Director, Virtual Utilization Review

• Perform admitting duties for all patients admitted for hospital services
• Assign accurate MRNs
• Complete medical necessity and compliance checks
• Provide patient instructions
• Collect insurance information
• Receive and process physician orders
• Utilize an overlay tool while providing excellent customer service
• Operate the telephone switchboard to relay incoming, outgoing, and inter-office calls
• Meet assigned point-of-service goals
• Use quality auditing and reporting systems to ensure accounts are corrected
• Conduct account audits and provide statistical data to Patient Access leadership
• Pre-register patient accounts before visits
• Make inbound and outbound calls to obtain demographic, insurance, and patient financial information
• Collect point-of-service collections and past-due balances, including payment plan options
• Explain general consent forms, obtain signatures, and document witnesses
• Explain and distribute patient education and required regulatory forms
• Review insurance eligibility responses and select applicable insurance plan codes
• Enter benefit data to support point-of-service collections and billing processes
• Screen medical necessity using Advanced Beneficiary Notice software
• Distribute and document ABNs and other designated forms and pamphlets

• Serve as a key resource for patients throughout their financial journey, from admission through post-discharge
• Review benefits and estimate out-of-pocket costs
• Facilitate payment arrangements and ensure compliance with organizational and regulatory requirements
• Conduct Medicaid screening and/or financial assistance eligibility reviews
• Calculate patient liability estimates and collect payments at point of service
• Address billing and coverage inquiries and maintain accurate account documentation
• Educate patients and resolve problems to enhance patient experience and financial performance
• Monitor trends, prepare operational reports, and support process improvement initiatives
• Meet productivity and department KPIs
• Triage patient financial questions and ensure resolution while patients are in-house
• Connect face-to-face with patients throughout their care journey
• Escalate identified financial process gaps
• Communicate and collaborate with case management, social workers, physician liaisons, and other personnel
• Perform other duties as assigned

Senior Financial Navigating Specialist

• Organize and coordinate activities of assigned Patient Access staff
• Handle and solve problems related to the assigned area
• Work with the Patient Access Manager to develop and coach staff
• Conduct and oversee orientation and training of Patient Access staff
• Perform Revenue Cycle tasks to ensure compliance and excellent customer service
• Coordinate registration and pre-registration duties and ensure completion daily
• Monitor daily productivity and communicate with staff
• Provide and review performance reporting on point of service, wait times, overtime, productivity, and other metrics
• Assign and coordinate staff schedules, rotations, time off, and call-offs
• Track and monitor upfront collection processes and assign goals
• Provide coaching and corrective action as appropriate
• Participate in an on-call rotation and provide administrative and educational guidance
• Develop department processes and procedures
• Conduct staff training, education, development, and performance audits
• Act as a resource for staff and ancillary departments
• Manage assigned projects involving implementation, tracking, and process changes
• Report routinely to Patient Access Leadership
• Participate in facility activities and gather statistical information
• Work in designated department areas as needed
• Assist with staff evaluations and maintain the time/attendance system
• Attend facility meetings as required

Senior Product Manager

Utilization Review Supervisor

Patient Access Specialist

Senior Accounts Receivable Specialist

Project Manager

Manager, Financial Planning & Analysis

Patient Access Specialist

Patient Access & Pre-Access Supervisor

Clinical Documentation Manager

Senior Auditor, Nursing

Patient Access Associate Specialist

Director, Virtual Utilization Review

Patient Access Associate Specialist

Senior Financial Navigating Specialist

Patient Access Supervisor