Sr Specialist, Transfer Diagnosis Related Group

Ensemble Health Partners

Base: $22.45 - $24.70ph; bonus/equity: bonus incen...
Fully remote
1-2 years hospital insurance claims experience
Working knowledge of hospital revenue cycle
Basic knowledge of medicare and managed medicare concepts
Ensemble Health Partners is seeking a Sr Specialist in Transfer Diagnosis Related Group, focusing on identifying underpayment opportunities related to Medicare claims. The position is fully remote and emphasizes a culture of empowerment, innovation, and exceptional client service

Job Summary

  • This position involves working from inventory reports to identify potential transfer DRG underpayment opportunities using proprietary software and CMS resources.
  • The role requires reviewing patient medical records and contacting post-acute providers to determine dates of service and level of care provided.
  • Ensemble Health Partners offers comprehensive benefits including paid certifications, tuition reimbursement, and bonus incentives for high performers.

Matching Summary

Match Score: 85

Ensemble Health Partners is seeking a Sr Specialist in Transfer Diagnosis Related Group, focusing on identifying underpayment opportunities related to Medicare claims. The position is fully remote and emphasizes a culture of empowerment, innovation, and exceptional client service.

Salary

Base: $22.45 - $24.70/hr; Bonus/Equity: Bonus Incentives available; Benefits: Comprehensive benefits package including healthcare and retirement

Skills & Requirements

Must-have

  • 1-2 years hospital insurance claims experience
  • Working knowledge of hospital revenue cycle
  • Basic knowledge of Medicare and managed Medicare concepts
  • Proficiency in Microsoft Office Excel Word Teams

Nice-to-have

  • Strong analytical skills for identifying underpayments
  • Effective communication and organization skills
  • Bachelor's degree preferred over associate degree
  • Ability to challenge the status quo

Key Requirements

  • Minimum of 1-2 years experience with hospital insurance claims
  • Associate degree or equivalent work experience required
  • Bachelor's degree preferred

Work Rights

Not specified

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