Senior Inpatient Insurance Authorization Specialist

ensemblehp; United States; Remote; USD 55,000 - 76,000; Full time

Job summary

Ensemble Health Partners is seeking a Bedded Insurance Authorization Senior Specialist to manage initial and concurrent insurance authorization, clinical submission, and denial prevention for hospital-admitted patients. You will also lead staff training, onboarding, audits, and unbilled cleanup while ensuring compliance with regulatory requirements.

You will verify eligibility, benefits, and obtain timely authorizations, aiming for high accuracy and productivity.

Qualifications

• Minimum 2 years of customer service experience.
• Experience with insurance companies and/or medical authorizations.
• Understanding of CPT codes and medical terminology.

Responsibilities

• Perform initial and concurrent insurance authorization for admitted patients.
• Submit clinical information to ensure appropriate authorization and medical necessity.
• Obtain and maintain patient-specific authorizations in a timely manner.
• Conduct staff training, onboarding, and quality audits.
• Reduce pre-bill denials and unbilled authorization follow-up.
• Support leadership with team engagement and performance metrics.

Education

High School Diploma/GED

CRCR Certification

Job description

Ensemble Health Partners is seeking a Bedded Insurance Authorization Senior Specialist to manage initial and concurrent insurance authorization, clinical submission, and denial prevention for hospital-admitted patients. You will also lead staff training, onboarding, audits, and unbilled cleanup while ensuring compliance with regulatory requirements.

You will verify eligibility, benefits, and obtain timely authorizations, aiming for high accuracy and productivity.