Clinical Appeals Specialist

5 days ago


Reading, Pennsylvania, United States Ensemble Health Partners Full time

Ensemble Health Partners is a pioneering provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. Our comprehensive suite of point solutions empowers clients across the country to optimize their revenue cycles.

We prioritize healthcare by keeping hospitals healthy. Our approach emphasizes a human touch in every interaction, recognizing that meaningful connections drive exceptional outcomes. By empowering our people to challenge the status quo, we foster a culture of innovation and collaboration.

The RN Clinical Appeals role offers a unique opportunity to make a tangible impact on patient care and financial outcomes. As a key member of our team, you will analyze and resolve clinically related claim denials, collaborate with stakeholders to prevent future denials, and prepare appeals materials. Your expertise will be instrumental in ensuring timely and effective communication with payers and healthcare providers.

This position requires a skilled professional with 1-3 years of experience in denials, utilization review, or case management. A Bachelor's degree and strong analytical skills are essential. Type 35 wpm proficiency and experience in hospital operations, chart audit/review, and provider relations are highly valued.

We offer a competitive salary range of $63,100.00 - $78,875.00 per year, commensurate with experience. Our benefits package includes comprehensive insurance, time off, retirement plans, and well-being programs. Professional growth opportunities, tuition reimbursement, and certification support ensure your continued development.

In addition to a dynamic work environment, Ensemble Health Partners prioritizes work-life balance and recognizes individual contributions through quarterly and annual incentive programs. Join us in shaping the future of healthcare revenue cycle management.



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