Full-Time
Revenue Integrity Analyst
Posted on 9/25/2025
Ensemble Health Partners
5,001-10,000 employees
End-to-end revenue cycle management for hospitals
Compensation Overview
$47.4k - $81.8k/yr
Remote in USA
Remote
 Finance & Banking (1) |
|---|
- 3-5 years related experience required
- Excellent knowledge of Epic, Excel and SQL queries
- Working knowledge of CPT & HCPCs coding guidelines
- Excellent computer, proof reading, and written and verbal communication skills
- Excellent interpersonal skills including the ability to communicate effectively with CHP internal and external customer base
- Ability to work independently, proactively with limited supervision and also as a team player when called upon
- Ability to work under pressure
- Ability to maintain the security of confidential information
- Bachelor’s Degree or equivalent experience
- CRCR Required within 9 months of hire (company paid)
- Evaluates current charging processes to diagnose the root cause of any charge inefficiencies and ensures standard charge practices are implemented
- Analyzes changes to coding and billing rules and regulations and using independent decision making to ensure appropriate updates to CDM and charge processes are implemented
- Prepare and present quarterly and annual CPT/HCPCS changes, annual pricing updates and provide client education material and presentation
- Conduct thorough research to ensure the Charge Description Master (CDM) is maintained regularly
- Leads efforts of collaboration with multi-disciplinary groups responsible for monitoring and assuring the accuracy and enhancement of hospital net revenue through management of the hospital charge master
- Collaborates with stakeholders in revenue enhancement projects including Denial Management, APC Billing and/or other committees as needed
- Provides leadership and expertise with various groups to develop new areas of review for future revenue enhancement and/or compliance initiatives
- Conduct thorough analysis of billing errors and denial data to diagnose root causes
- Utilizes independent decision making to execute work plans to correct identified deficiencies related to charge problems
- Stay up-to-date with industry trends, emerging technologies, and regulatory changes affecting healthcare revenue cycle management and proactively share knowledge with the team
- Perform Quality Assurance on team members, as needed
- Trending and analysis of key data to identify areas for additional education
- Serves as subject matter expert (SME) of charge capture methodologies and helps investigate and solve charging issues and provide charge capture recommendations to clinical departments and hospital staff
- Collaborate with client leadership to ensure charge trigger matrix is clearly documented and updated, as needed
- Diagnoses root cause issues of charge problems and provides client education for best practice recommendations for improvement
- Conduct root cause analysis on late charge reporting and provide client education for timely charge capture
- Ensure effective monitoring and internal control processes in place to improve revenue capture
- Rounding on client revenue leaders on a quarterly basis to review questions concerning charge reconciliation, charge processes, CDM
- Attend meetings to support system conversions, revenue cycle initiatives and foster good working relationships with key contacts
- Identify operational performance and revenue opportunities through detailed data review
- Ensure effective monitoring and reporting control processes in place to improve performance
- Evaluation of current processes and tools and propose changes in order to drive efficiencies within Revenue Cycle
- Coordinate operational objectives by contributing information and recommendations to strategic plans and reviews; preparing and completing action plans
- This position will be proactive in auditing and reconciling his/her own data findings, report results in order to maintain improve the quality and integrity data provided by the analyst
Ensemble Health Partners provides end-to-end revenue cycle management for hospitals and health systems. It handles the entire process from patient intake to final payment, with teams and technology embedded into the provider's operations and a revenue model tied to performance improvements. The company uses its proprietary EIQ platform (analytics, AI, and workflow automation) to optimize revenue cycle processes, reduce insurance denials, and speed cash collection, managing more than $39 billion in net patient revenue. Its approach differentiates it by being a true managed-services partner with full accountability for financial outcomes and a track record of meeting initial client goals. The overarching goal is to improve healthcare providers’ financial performance so they can focus on patient care.
Company Size
5,001-10,000
Company Stage
N/A
Total Funding
N/A
Headquarters
Huntersville, North Carolina
Founded
2014
Simplify's Take
What believers are saying
- Carilion Clinic selected Ensemble July 2024 for comprehensive RCM outsourcing.
- Mary Washington Healthcare partnered October 2024, expanding mid-sized client base.
- Cohere AI autonomously manages 40% AR tasks, boosting denial overturns 15%.
What critics are saying
- Cohere discontinues North platform within 18 months, paralyzing 40% AR operations.
- Microsoft Azure pricing surges in 12 months, crippling EIQ generative AI capabilities.
- Major client like Carilion terminates contract in 12 months, slashing recurring revenue.
What makes Ensemble Health Partners unique
- Ensemble delivers end-to-end RCM with full accountability for client financial performance.
- Proprietary EIQ platform integrates AI and analytics for denial reduction and cash acceleration.
- First RCM-native LLM built with Cohere handles complex tasks HIPAA-compliantly.
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Benefits
Health Insurance
Professional Development Budget
Performance Bonus
Flexible Work Hours
Comprehensive Benefits
Company News
Ensemble, a US revenue cycle management services provider, has partnered with enterprise AI company Cohere to build the healthcare industry's first revenue cycle management-native large language model. The companies are creating a custom model informed by Ensemble's operational expertise and data, designed to handle complex healthcare financial operations more accurately than general-purpose LLMs. The model will be embedded into AI agents managing processes from patient intake to account resolution. Unlike standard approaches that rely on prompt engineering, this system is fine-tuned on real RCM tasks and trained using synthetic datasets in a HIPAA-compliant environment, without using identifiable patient data. The solution aims to enhance existing electronic health record systems by providing better context and guidance for navigating payer requirements whilst reducing administrative burden for healthcare providers.
The article discusses the transformative impact of technology on healthcare, highlighting Ensemble Health's billion-dollar valuation amid a shift towards AI, telehealth, and extended reality. AI advancements promise personalized medicine, while telehealth evolves with Remote Patient Monitoring. The metaverse emerges as a tool for training and therapy. Challenges include data privacy, interoperability, and cybersecurity. The goal is a more personalized, accessible, and proactive healthcare system.
What You Should Know:– Ensemble, a leading provider of end-to-end revenue cycle management (RCM), has partnered with Cohere, a security-first enterprise AI company, to introduce the first fully integrated agentic AI platform for revenue cycle orchestration in healthcare.– This collaboration merges Ensemble’s decade-long RCM expertise with Cohere’s enterprise-grade AI infrastructure to deliver faster, smarter, and more secure financial operations for hospitals and health systems.Advancing Revenue Cycle Intelligence with Secure, Scalable AI IntegrationEnsemble has integrated Cohere’s enterprise-grade AI models—trained on a decade of Ensemble’s high-performing revenue cycle outcomes—throughout its entire RCM infrastructure. This collaboration represents the inaugural healthcare deployment of Cohere’s North platform, establishing a new benchmark for secure, scalable agentic AI within clinical financial operations, all while ensuring full HIPAA compliance and data integrity.In contrast to traditional, narrowly focused AI tools, Ensemble and Cohere have co-engineered a horizontally deployed network of reasoning-based agents. These AI agents leverage contextual data analysis and adaptive decision-making frameworks to resolve multifaceted revenue cycle challenges, particularly in insurance reimbursement, without depending on inflexible rule sets.A human-in-the-loop architecture reinforces the platform’s operational integrity, embedding rigorous quality assurance mechanisms across every decision layer. Currently, this system autonomously manages more than 40% of accounts receivable (AR) follow-up tasks—previously handled manually—and is on track to expand into additional complex workflows, including prior authorization, utilization management, clinical coding, and denial prevention.The broader AI ecosystem features:• Generative AI trained on clinical documentation to enhance the accuracy and speed of denial appeals• Conversational AI modules designed to streamline patient interactions and reduce call resolution time• Predictive analytics tools for early identification of denial risks• Agent assistants that augment frontline staff productivityThese technologies are already delivering tangible operational benefits, including:• A 40% increase in the speed of denial appeal submissions• A 15% uplift in appeal overturn rates• A 35% reduction in patient call resolution times• Improved overall patient satisfaction metricsCohere was selected for its proven capacity to implement secure AI solutions in highly regulated environments. Its North infrastructure ensures seamless, secure integration across diverse platforms—including provider host systems, payer portals, and internal administrative tools—while upholding the highest standards of data privacy and system interoperability.Nick Frosst, Co-Founder of Cohere, remarked, “Working with Ensemble to bring secure AI into healthcare—where data privacy is a deeply personal issue—is an incredible opportunity. By working together, we’re setting a new standard for tackling some of healthcare’s toughest administrative challenges and showing how agentic AI makes a real-world difference.”
Cincinnati, OH, Oct. 16, 2024 (GLOBE NEWSWIRE) -- Ensemble, the partner of choice for end-to-end revenue cycle management for mid-sized to large healthcare organizations, has been named a Leader in Everest Group’s RCM Operations PEAK Matrix® Assessment 2024. According to the assessment, Ensemble is the highest-designated leader for market impact reflecting not only the strength of its vision, expertise and approach to technology, but the unmatched value delivered at scale to a rapidly growing and highly satisfied client base. “This latest recognition validates our commitment to client satisfaction, delivering a frictionless revenue cycle and providing significant value for leading healthcare systems across the country,” said Ensemble Founder, President and CEO Judson Ivy. “The healthcare revenue cycle is growing increasingly more complex due to changing regulations, reimbursement requirements and rapid shifts in payer policy. We are proud to be recognized as a leader for our excellence in improving financial outcomes and patient experiences so providers can hyper-focus on delivering high-quality care to their patients and communities.” According to Everest Group, Ensemble’s strengths include value delivered, vision and strategy, innovation and investments and scope of services offered
Cincinnati, OH, Oct. 03, 2024 (GLOBE NEWSWIRE) - Ensemble, the market leader in revenue cycle management for mid-sized to large healthcare organizations, announced today that is has been selected by Mary Washington Healthcare (MWHC) as their strategic revenue cycle management partner.