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

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 GED
• 2+ 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 Workplaces USA
• Fortune Media Best Workplaces in Healthcare 2024
• Monster Top Workplace for Remote Work 2024
• Great Place to Work certified
• 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…