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Denials Supervisor

Role overview

Qualifications

  • Registered Nurse or Licensed Practical Nurse
  • 1 to 3 years of job experience
  • Less than 3 years of people leadership experience
  • Associates Degree or Equivalent Experience

Responsibilities

  • Review daily inventory and adjust staff assignments for optimal claim recovery
  • Address issues presented by staff and customers for claim resolution
  • Assist with identifying educational needs and resources for staff
  • Participate in hiring, performance management, and employee evaluations

About the company

Ensemble Health Partners logo

Ensemble Health Partners

Ensemble manages more than $35 billion in net patient revenue (NPR) and partners with more unique health systems than any other revenue cycle firm to deliver holistic financial health solutions through end-to-end managed services partnerships. The firm helps providers maximize their current technology and deploys industry-leading solutions to meet the unique needs of their systems and patients. Ensemble focuses on delivering value quickly and sustaining high performance, meeting 100% of year-one client goals, exceeding 102% of year-one cash collections and delivering 5% average NPR lift across clients.

Company details

Company typeXLarge
Company size10001

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Job 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

This position pays between $52,100.00 - $78,150.00/based on experience

The RN/LPN Denial Supervisor is responsible for day-to-day operations related to reviewing of denials and drafting of appeals by the Denials/Audit Nurse Specialists. The Supervisor provides daily operational support to the Nurse Denial Specialists and facilitates communication between teams to ensure appeal processes are performed efficiently and effectively.  The Supervisor manages denial workflow throughout the team and participates in activities of Denial Management that will provide an opportunity to identify areas for improvement in workflow and quality of work performed. The Supervisor will participate in Human Resource activities that will both evaluate and enhance the knowledge and skill set of the Denials/Audit Nurses.

Essential Job Functions:

  • Reviews daily inventory and makes adjustments to staff assignments in order to focus on areas that will bring the greatest return on claim recovery.

  • Addresses issues presented by staff and other customers to assist with claim resolution which may include collaboration with superiors, peers, other departments, and payers.

  • Assists the SMART (Specialized Mentor and RevCycle Trainer) with identifying educational needs and providing resources to new hires and existing staff.

  • Assists manager with interviewing, hiring and performance management and development of staff; assist with counseling and discipline of employees when necessary, in accordance with department and/or organizational policies; participate in mid-year and yearly evaluations.

  • Attends payer meetings to lead clinical denial issues; Services as backup support for department, facility and other meetings as needed.

This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Associates may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.

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.

Legally Required License:

  • Registered Nurse or Licensed Practical Nurse

Job Experience:

  • 1 to 3 years

People Leadership Experience:

  • Less than 3 Years

Education Level:

  • Associates Degree or Equivalent Experience

Preferred Area of Study:

  • Nursing

Preferred Knowledge, Skills and Abilities:

  • Experience in Hospital Operations, Denial Management, Case Management, Utilization Review, and/or prior clinical experience preferred.

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.

Employment Disclaimers – Ensemble

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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