Senior Insurance Authorization Specialist
The Opportunity
The Senior Insurance Authorization Specialist is responsible for supporting the Insurance Authorization Specialist I and Insurance Verification Specialists I while performing insurance authorization and verification for all patients scheduled for services at Ensemble Health Partners. They are responsible for performing these functions while meeting the mission of Ensemble Health Partners and all regulatory compliance requirements.
This position starts at: $18.65/hr. Final compensation will be determined based on experience. This position is an on-site role at Bon Secours - St Mary's Hospital in Richmond, VA.
Job Responsibilities
- Select accurate medical records for patient safety, obtain and validate demographic and insurance information, work with insurance companies and/or physician offices to complete insurance authorization requirements to secure payment, and ensure active/eligible coverage.
- Assist the supervisor of the department with escalated issues, tracking system and process issues as well as assisting in the training and mentoring of new hires.
- Aid the Insurance Authorization Specialists I and Insurance Verification Specialists I in achieving:
- 95% accuracy/quality while handling accounts, as measured by account audits
- 95% quality of expected customer service etiquette, as measured by phone call audits
- Identify the appropriate clinical records and submit the authorization request to the insurance company based on plan requirements for approval. Will be the liaison between the ordering physician and insurance company to ensure all requirements to secure approval are identified and communicated.
- Perform other duties as assigned.
Experience We Love
- 1-3 years of 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.
Minimum Education
High School Diploma/GED Required
Preferred Education
2 Year/ Associates Degree
Certifications
Certified Revenue Cycle Representative (CRCR) required within 9 months of hire -Company Paid
About the Role
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.
Benefits
- 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.
- Professional development opportunities through professional certifications and tuition reimbursement.
- Incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.
Company Information
- 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
- Energage Top Workplaces USA 2022-2024
- Fortune Media Best Workplaces in Healthcare 2024
- Monerst Top Workplace for Remote Work 2024
- Great Place to Work certified 2023-2024
Equal Employment Opportunity
We are 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.