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.
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.
- 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.
- Achieve >95% accuracy/quality while handling accounts, as measured by account audits and >95% quality of expected customer service etiquette, as measured by phone call audits.
- Maintain productivity standards set by the team.
- 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.
- Perform other duties as assigned.
Experience We Love
- 1-3 years of experience in a similar role.
- 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.
- Experience with authorization or revenue cycle processes for physician-administered medications, injections, infusions, or genetic testing is preferred.
Minimum Education
A High School Diploma/GED is required. A 2 Year/ Associates Degree is preferred.
Certifications
A Certified Revenue Cycle Representative (CRCR) certification is required within 9 months of hire.
Company Information
- Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups.
- Ensemble offers 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.
- By empowering our people to challenge the status quo, we know they will be the difference!
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, including earning a professional certification relevant to their field and obtaining tuition reimbursement.
- Quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.
About the Role
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.