Bedded Insurance Authorization Supervisor

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 Bedded Insurance Authorization Supervisor is responsible for overseeing staff performing initial and concurrent insurance authorization securement, clinical submission and denial prevention for all patients admitted to the hospital for clients. The supervisor is responsible for overseeing and conducting staff training, and onboarding, quality audits, Unbilled clean-up and reduction and Pre-Bill Denials processing. The Supervisor will be responsible for the coaching and development of all staff performing these functions and assisting in implementing short and long-term plans and objectives to improve customer service and collect quality information. While performing these functions they are required to maintain the mission and goals of Ensemble Health Partners and all regulatory compliance requirements. 

Job Responsibilities:

• Supervises daily activities of the Bedded Insurance Authorization staff while monitoring work queues to mitigate risk.  Staff are responsible for obtaining and validating insurance information, working with insurance carriers to complete notification of admission, authorization & bed day securement and clinical submissions for all hospital admissions.

• Responsible for the coaching and development of all staff performing these functions and assisting in implementing short and long-term plans and objectives to improve customer service and collect quality information.

• As a subject matter expert, this person must provide leadership and contribute to the revenue cycle and organizational goals and is responsible for meeting the mission and regulatory compliance requirements.

• Assists in strategic planning and performs ongoing process improvement evaluation.  Reviews, updates and implements policies and procedures to support the vision and goals.

• Ensures staff achieve:  >95% accuracy/quality and productivity and oversees all quality audits and training.

• Conducts all staffing metric reviews both monthly and quarterly and weekly team time.

• Collects, interprets and communicates performance data using various tools and systems, while also using this data to make decisions on how to achieve performance goals with Pre-Access leaders.

• Prevention of delayed claims process through daily Unbilled authorization follow-up and reduction and Pre-Bill Denials & P2P processing.  

• Assists leader with team engagement while fostering positivity for driving performance.

• Demonstrates the knowledge and skills necessary to provide care appropriate to the age of the patients served on his or her assigned unit.  

• Demonstrates knowledge of the principles of growth and development of the life span and possesses the ability to assess data reflective of the patient's status and interprets the appropriate information needed to identify each patient's requirements relative to his or her age, specific needs and to provide the care needed as described in departmental policies and procedures.

Experience:

• 3-5 years management experience in healthcare industry

• Epic experience

• Must have excellent organizational skills with formal typist at a minimum of 45 WPM.

• Must have intermediate to expert proficiency in MS applications (Word, Excel & PowerPoint), experience with multiple computer systems and use of dual screens.

• Must have experience working with insurance companies and/or medical authorizations.

• Must have comprehensive understanding of insurance authorization requirements, contract benefits, CPT codes and medical terminology.

• Work requires a high level of critical thinking and problem-solving skills and the ability to retain material quickly and work in a group setting and independently.

• Must demonstrate a positive d