Insurance Authorization Specialist

Ensemble Health Partners; Kentucky; Hybrid; USD 15,000 - 25,000; Full time

Benefits offered by this job

Tuition reimbursement

Comprehensive benefits

Career advancement

Job summary

Ensemble Health Partners is seeking an Insurance Authorization Specialist to perform insurance authorizations for patients, coordinating with physicians and insurers to obtain approvals. The role requires accurate record selection, knowledge of coding/billing regulations, and the ability to adapt processes to meet evolving requirements.

The position is remote, with potential onsite travel as needed. Requires high school diploma, 2+ years of experience, and CRCR certification within 9 months.

Qualifications

• 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.
• Strong written communication and interpersonal skills.
• Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation.

Responsibilities

• Perform insurance authorization for patients scheduled for services.
• Coordinate between ordering physicians and insurance companies to secure approval.
• Identify appropriate records and submit authorization requests according to plan requirements.

Skills

Medical coding knowledge

Billing systems proficiency

Analytical thinking

Written and interpersonal skills

Adaptability to new processes

Education

High school diploma or GED

Tools

CRCR certification

Job description

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 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” 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 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 and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation. Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement. Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.

Ensemble is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble also prohibits harassment of applicants or employees based on any of these protected categories. Ensemble provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact [e-mail]. This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role’s range.

We believe that our core values of trust, integrity, loyalty and service married with the belief that our work is worthwhile helps us build and sustain sincere relationships with our associates and clients. If you are a passionate, dedicated and experienced revenue cycle, consulting or finance professional and seek career and personal growth, we would love to hear from you. We believe we foster an environment where talented individuals can excel and shine. Our team believes that people are the most important part of our success and that when we take care of our people, they pay it forward by providing our clients with excellent results and world-class service.