Insurance Authorization Specialist

About the role

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement The position pays between $17.00 - $18.65/hr based on experience The Insurance Authorization Specialist performs insurance authorization 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. The Insurance Authorization Specialist I will work within the policies and processes as they are being performed across the entire organization. . Essential Job Functions: The Insurance Authorization Specialist is responsible for selecting accurate medical records for patient safety, and working with insurance companies and/or physician offices to complete insurance authorization requirements to secure payment. This role will identify the appropriate clinical records and submit the authorization request to the insurance company based on plan requirements for approval. The Insurance Authorization Specialist I will be the liaison between the ordering physician and insurance company to ensure all requirements to secure approval are identified and communicated requirements to secure payment. This role will identify the appropriate clinical records and submit the authorization request to the insurance company based on plan requirements for approval. Among the expectations of this role, the Specialist will achieve>95% accuracy/quality while handling accounts >95% quality of expected customer service etiquette Meet or exceed Lower controls of average productivity amongst the Insurance Authorization Specialist I productivity standards Performs other duties as assigned

Requirements

• 1 to 3 years' experience in a healthcare setting. Experience working with insurance verification and authorization requirements.
• High School Diploma, GED, or Equivalent 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.
• Experience We Love:
• Understanding of Revenue Cycle including admission, billing, payments and denials. Comprehensive knowledge of patient insurance process for obtaining authorizations and benefits verification. Knowledge of Health Insurance requirements. Knowledge of medical terminology or CPT or procedure codes.
• 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 Bene

Benefits

Additional Information

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.

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