• Responsible for timely and compliant Private Duty billing, authorizations, and reimbursement for designated region • Work directly with revenue cycle director, billing compliance coordinator, agencies, and intermediary to facilitate billing claims • Obtain authorizations as needed • Prepare, audit, and submit claims electronically for appropriate payment • Follow up on outstanding claims and take appropriate action for timely payment • Collect necessary information to prepare claims, coordinating with agencies when appropriate • Bill and submit clean claims electronically and follow up with the Payer • Process, collect, and manage account payments • Monitor claims daily, report totals • Research, correct, and re-submit rejected and denied claims • Follow-up on corrections and report adjustments using revenue cycle management tool • Monitor and maintain assigned accounts • Review billing reports to maintain accurate AR balances • Document follow-ups on claim outstanding balance until final resolution is reached • Keep accurate and orderly records for all billing and accounts receivable activity • Conduct pre-billing audits as assigned • Proactive in identifying potential reimbursement issues while ensuring effective problem resolution • Coordinate with the Agency and Billing Compliance Coordinator on relevant process issues impacting billing • Report any billing issues that develop into trends to immediate supervisor • Answer questions from patients, agency staff, and insurance companies • Interpret and process Explanation of Benefits when needed • Professionally make outbound calls while improving customer relations • Maintain knowledge of current industry standards related to billing and cognizant of new regulations

Role Description This position is located in the Health Information Management (HIM) section at the Robley Rex VA Medical Center. MRTs (Coder) are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings, such as physician offices, group practices, multi-specialty clinics, and specialty centers. - This job opportunity announcement (JOA) will be used to fill one (1) full-time and permanent Supervisory Medical Records Technician (Coder) vacancy at the Louisville, KY Veteran Affairs Medical Center (VAMC), with Business Office Service. - MRTs (Coder) analyze and abstract patients' health records and assign alpha-numeric codes for each diagnosis and procedure. - Must possess expertise in: - International Classification of Diseases (ICD) - Current Procedural Terminology (CPT) - Healthcare Common Procedure Coding System (HCPCS) - Provide education related to coding and documentation. - Supervisory MRTs (Coder) are responsible for: - Supervising coding staff at the facility level. - Performing all duties of a MRT (Coder). - Administrative management and direction of coding staff. - Program management of a coding section/unit to ensure performance monitors are established and met. - Evaluating performance of subordinate staff. - Approving sick and annual leave requests. - Identifying educational or training needs. - Resolving employee complaints and taking disciplinary actions, when necessary. - Informing higher-level management of anticipated vacancies or increases in workload. - Recommending employees for promotions, reassignments, recognitions, retention or release of probationary employees, or other changes of assigned personnel. - Making decisions on the selection of employees for vacant or new positions. - Serving as an expert coding resource to ensure accuracy and integrity of all coding. - Collaborating with revenue, compliance, and other departments to support coding accuracy consistent with official guidelines. - Resolving claim edits referred to coding management and monitoring reports for outstanding services, rejects, or un-coded episodes of care. - Ensuring claim denials related to coding errors are resolved, and/or daily coding rejects are corrected for accurate billing and data collection. - Providing education to clinical and coding staff. - Assessing current audit findings and evaluating impact to coding and documentation practices. - Overseeing the reporting of coding and documentation audit results to leadership. - Collecting and preparing data for studies involving inpatient stays and outpatient encounters for clinical evaluation purposes. - Preparing and maintaining a variety of complex records and reports as requested. - Creating and monitoring outpatient reports, inpatient case mix reports, top DRGs, and key performance indicators to identify patterns, trends, and variations. - Investigating and evaluating potential causes for changes or problems and collaborating with appropriate staff to effect resolution or explain variances. - Participating in the formulation of objectives and strategies utilizing coded data to support goals for patient care, teaching, research, and optimizing management of resources. - Supervisory MRTs whose assignments involve two or more MRT specialty areas will be assigned the parenthetical title for the predominant specialty area. Qualifications - United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. - Experience or Education: - One year of creditable experience indicating knowledge of medical terminology, anatomy, physiology, pathophysiology, medical coding, and the structure and format of health records. - OR An Associate's degree from an accredited college or university with a major field of study in health information technology/health information management, or related degree with a minimum of 12 semester hours in health information technology/health information management. - OR Completion of an AHIMA approved coding program, or other intense coding training program of approximately one year or more. - OR Experience/Education Combination. - Certification: Persons hired or reassigned to MRT (Coder) positions in the GS-0675 series in VHA must have either: - Apprentice/Associate Level Certification through AHIMA or AAPC. - Mastery Level Certification through AHIMA or AAPC. - Clinical Documentation Improvement Certification through AHIMA or ACDIS. - Physical Requirements: See VA Directive and Handbook 5019, Employee Occupational Health Service. - English Language Proficiency: MRTs (Coder) must be proficient in spoken and written English as required by 38 U.S.C. § 7403(f). Requirements - Grade Determinations: - GS-10 Supervisory Medical Records Technician (Coder): One year of creditable experience equivalent to the next lower grade level. - Experience is only creditable if it is directly related to the position to be filled. - Employees at this level must have a mastery level certification. - Mastery Level Certification must represent a comprehensive competency in the occupation. Benefits - Relocation/Recruitment Incentives: Not authorized. - Permanent Change of Station (PCS): Not authorized. Company Description IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education. Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment.

Role Description This position is located in the Health Information Management (HIM) section at the Robley Rex VA Medical Center. MRTs (Coder) are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings, such as physician offices, group practices, multi-specialty clinics, and specialty centers. This job opportunity announcement (JOA) will be used to fill one (1) full-time and permanent Supervisory Medical Records Technician (Coder) vacancy at the Louisville, KY Veteran Affairs Medical Center (VAMC), with Business Office Service. Responsibilities include: - Analyzing and abstracting patients' health records and assigning alpha-numeric codes for each diagnosis and procedure. - Possessing expertise in International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and the Healthcare Common Procedure Coding System (HCPCS). - Providing education related to coding and documentation. - Supervising coding staff at the facility level. - Performing all duties of a MRT (Coder). - Managing coding staff and ensuring performance monitors are established and met. - Evaluating the performance of subordinate staff and approving leave requests. - Identifying educational or training needs and resolving employee complaints. - Making decisions on the selection of employees for vacant or new positions. - Collaborating with revenue, compliance, and other departments to support coding accuracy. - Resolving claim edits referred to coding management. - Providing education to clinical and coding staff. - Collecting and preparing data for studies involving inpatient stays and outpatient encounters. - Creating and monitoring outpatient reports, inpatient case mix reports, top DRGs, and key performance indicators. - Participating in the formulation of objectives and strategies utilizing coded data. Qualifications - United States Citizenship. - One year of creditable experience that indicates knowledge of medical terminology, anatomy, physiology, pathophysiology, medical coding, and the structure and format of health records. - An Associate's degree from an accredited college or university in health information technology/management, or related degree with a minimum of 12 semester hours in health information technology. - Completion of an AHIMA approved coding program or other intense coding training program. - Equivalent combinations of creditable experience and education are qualifying. - Certification through AHIMA or AAPC is required. Requirements - Proficiency in spoken and written English. - Physical requirements include primarily sedentary work with some walking, bending, and reaching. - Experience must be documented on the application or resume and verified in an employment reference. Benefits - Not authorized for relocation/recruitment incentives. - Permanent Change of Station (PCS) not authorized.

Title: Pro Fee Coding Educator – Special Projects Location: Work at Home - Other 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 $62,500 to $119,700 annually based on experience We are seeking a highly skilled Coding Educator to join our Special Projects Team within our Client Integration Department. This role is critical in conducting provider audits, focusing on E&M, Surgical, and in-office procedures. We analyze the full picture of how charges are processed, including documentation, coding, and patient history. This role requires travel via air or car 20-40% of the time. Job Responsibilities: - Perform manual audits based on provider, client, or coding concerns, typically beginning with a 30-chart probe to assess potential documentation or coding discrepancies. - Deliver audit results and summary to the director over the client and implement necessary corrections. - Identify and elaborate on education opportunities within audits to ensure discrepancies are addressed (though direct provider education is typically handled by compliance or Ensemble’s education team- this may change in the future as our team develops). - Work collaboratively within a small, dynamic team while maintaining the ability to work independently and manage workloads effectively. - Confidently conduct research when unsure about coding scenarios and be proactive in asking questions to ensure accuracy. - Abstract codes from progress notes, procedure notes, and operative notes with precision. - Contribute to the development of workflows and processes as the team continues to establish best practices. - Participate in a 90–120-day smart training program to gain proficiency in our audit workflows. Experience We Love: - 5 + years of coding and educational experience in Professional Fee Coding or consulting setting with preference for Cardiology, General Surgery, Neurosurgery or Ob GYN specialties - Expert-level coding knowledge in E&M leveling, surgical, and in-office procedures. - Strong understanding of documentation and coding compliance. - Ability to analyze complex coding scenarios and identify areas for improvement. - Experience in auditing and education, with the ability to communicate findings effectively. - Confident researcher who is comfortable seeking out guidance and clarification when needed. - Ability to navigate or learn multiple EHR systems efficiently - Self-motivated and adaptable, capable of thriving in a developing team environment. - Required travel 20-40% of the time via air or car. - 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. Minimum Education: - Bachelors Degree or Equivalent Experience Certification/s Required: Candidates must have and keep current at least one of the following professional certifications (CPC, CPMA or CCS Preferred): - CPC (Certified Professional Coder) - CCS-P (Certified Coding Specialist-Phys Based) - CCS (Certified Coding Specialist) - RHIA (Registered Health Information Administrator) - RHIT (Registered Health Information Technician) - CIC (Certified Inpatient Coder) - COC (Certified Outpatient Coder) LI-HB1 LI-REMOTE 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