Bedded Senior Insurance Authorization/Verification Specialist

Thank you for considering a career at Ensemble Health Partners!

Ensemble Health Partners 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

The Opportunity:

The Insurance Verification/Authorization Specialist II is responsible to support the Insurance Authorization Specialist I and Insurance Authorization Specialist II roles 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. The Insurance Verification/Authorization Specialist II will work within the policies and processes as they are being performed across the entire organization. They'll support the Department's Supervisor with the daily workflow and distribution of workload, answer questions as the assigned subject matter experts, assist with mentoring and training new members of the team and report any system or process issues identified.

This position pays between $16.00 - $23.00/hr depending on experience

Essential Job Functions:

• The Insurance Verification/Authorization Specialist II will support the Insurance Authorization I staff in their responsibility for selecting accurate medical records for patient safety, obtaining and validating demographic and insurance information, working 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.
• Among the expectations of this role the Insurance Verification/Authorization Specialist II will assist 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 Meet or exceed Lower controls of average productivity amongst the team productivity standards 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 any and all requirements to secure approval are identified and communicated.
• Performs other duties as assigned

Requirements:

• 2 years’ experience in a healthcare setting. Experience working with insurance verification and authorization requirements.
• High School Diploma, GED, or Equivalent Experience
• Certified Revenue Cycle Representative (CRCR) required within 9 months of hire -Company Paid   

Experience We Love:

• 2 Year Associates Degree
• 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.
• Patient Access experience with managed care/insurance, formal typist with a minimum of 35 WPM, intermediate proficiency in MS applications (Word, Excel & PowerPoint), experience with multiple computer systems and use of dual screens. Able to multitask and work individually while applying critical thinking skills. Customer Service experience highly preferred.

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

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