Insurance Authorization Specialist

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:

ENTRY LEVEL CAREER OPPORTUNITY OFFERING:

Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $17.00 - $18.65/hr based on experience

The Insurance Authorization Specialist is responsible for performing insurance authorization for all patients scheduled for services. Insurance Authorization Specialist I will work within the policies and processes as they are being performed across the entire organization.

Insurance Authorization

Responsibilities include:

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.

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 any and all requirements to secure approval are identified and communicated.

Experience We Love:

Knowledge of appeals concepts and principles.

Advanced knowledge of medical coding and billing systems, documentation, and regulatory requirements.

Ability to use independent judgement and to manage and impart confidential information.

Ability to analyze.

Strong written communication and interpersonal skills.

Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation .Knowledge of current and developing issues and trends in medical coding procedures requirements.

Ability to clearly communicate medical information to professional practitioners and/or the general public.

Ability to adapt and modify medical billing procedures, protocol, and data management systems to meet specific operating requirements

Ability to provide guidance and training to professional and technical staff in area of expertise.

Ability to flex work schedule on an as needed basis to meet the business needs.

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.

Required Qualifications:

High school diploma or GED2+ years of Insurance Authorization experience

Certification:

Certified Revenue Cycle Representative (CRCR) required within 9 months of hire
-Company Paid Join an award-winning company

Five-time winner of “Best in KLAS” , Black Book Research's Top Revenue Cycle Management Outsourcing Solution Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024

Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, Energage Top…