Senior Insurance Authorization Specialist

Ensemble Health Partners; Richmond (VA); On-site; USD 25,000 - 34,000; Full time

Benefits offered by this job

Bonus Incentives

Paid Certifications

Tuition Reimbursement

Comprehensive Benefits

Career Advancement

Job summary

Ensemble Health Partners seeks a Senior Insurance Authorization Specialist for an on-site role at Bon Secours - St Mary's Hospital in Richmond, VA. You will support the Insurance Authorization I staff, ensure accurate records, and secure insurance approvals to maximize payment.

The role emphasizes accuracy, quality of service, and mentoring of junior staff, with opportunities for certification and career advancement.

Qualifications

• 1-3 years of experience in related role.
• High School Diploma or GED required.
• CRCR Certification required within 9 months of hire (Company Paid).

Responsibilities

• Select accurate medical records for patient safety and obtain/verify demographic and insurance information.
• Coordinate with insurers and physician offices to complete authorization requirements to secure payment.
• Maintain accuracy and quality targets (>95%); provide guidance and training to new hires.

Education

High School Diploma/GED

Job description

About Ensemble

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!

Compensation

This position pays between $18.65 - $25.00 depending on experience.

This position is an on-site role at Bon Secours - St Mary's Hospital in Richmond, VA.

Benefits

• Bonus Incentives
• Paid Certifications
• Tuition Reimbursement
• Comprehensive Benefits
• Career Advancement

Job Responsibilities

The Senior Insurance Authorization Specialist 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 Senior Insurance Authorization Specialist 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 all requirements to secure approval are identified and communicated.

Performs other duties as assigned.

Experience

Experience We Love: 1-3 years of experience

Minimum Education

Minimum Education: High School Diploma/GED

Preferred Education

Preferred: 2 Year/ Associates Degree2 Year/ Associates Degree

Certifications

Certifications: Certified Revenue Cycle Representative (CRCR) required within 9 months of hire -Company Paid

About the Award-Winning Company

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.

Benefits Details

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.

Culture

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 and Recognition

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.

Diversity and Inclusion

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.

Eligibility

Due to business, operational, payroll, and regulatory requirements, this position is limited to individuals who reside and are authorized to work within the United States. Applications generated from outside the United States will not be considered. Individuals may reapply when located within the United States.

Accommodations

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].

Compensation Transparency

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.