Lead Quality Specialist

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 $49,000.00 to $68,500.00 based on experience. Final pay will be determined based upon experience and equity.

The Quality Lead Specialist independently reviews and ensures the quality of Revenue Cycle teamwork efforts. Analyzes non-routine problems, develops solutions, and communicates practices and policies to reach agreement with others outside the job area.

Job Description:

• Performs quality reviews across multiple clients, documents business processes, and identifies operational, compliance, and quality risks, making recommendations to mitigate them.
• Mentors and trains other team members, assisting leadership in developing review plans, preparing quality reports, and ensuring implementation of review recommendations.
• Maintains current knowledge of relevant regulations, supports onboarding, and fosters a culture of innovation and excellence through proactive problem-solving and collaboration.
• Assesses the Quality Assurance process and actively looks for opportunities to increase efficiency and proactively brings to Leadership attention.
• Prepare and assist in presenting quality reports of review findings and recommendations to direct leadership for review and approval.
• 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.
• 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 Experience:

• 6 to 8 years of experience  in Quality Assurance
• At least 3 years Accounts Receivable experience
• Epic Payment system experience
• Revenue Cycle Management experience
• 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:

Associate’s 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.

Due to business, operational, payroll, and regulatory requirements, this position is limited to individuals who reside and are authorized to work within the United States. Applications generated from outside the United States will not be considered.  Individuals may reapply when located within the United States.

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 [email protected].

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