Senior Insurance Authorization Specialist - Infusion

Ensemble Health Partners; Kentucky; Hybrid; USD 26,000 - 32,000; Full time

Job summary

Ensemble Health Partners seeks a Senior Insurance Authorization Specialist to support accurate insurance authorizations and verifications for patients. You will assist the supervisor, mentor new staff, and ensure compliance across the organization.

Required are 1-3 years in a similar role, a High School Diploma/GED, and CRCR certification within 9 months of hire. Compensation ranges from $18.65 to $23.50 per hour, with benefits and growth opportunities.

Qualifications

• High School Diploma or GED is required.
• 1-3 years of experience in a similar role preferred.
• Must be inquisitive and open to innovation including AI.

Responsibilities

• Support Insurance Authorization I staff with selecting patient records and demographic data.
• Obtain and validate information, coordinate with insurers/physician offices to secure authorizations.
• Assist supervisors and mentor new hires; ensure accuracy and quality standards (>95%).

Education

High School Diploma/GED

Associate's degree

Job description

Introduction

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!

Opportunity

The Senior Insurance Authorization Specialist is responsible for supporting the Insurance Authorization Specialist I and Insurance Verification Specialists I 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 Senior Insurance Authorization Specialist 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 $18.65 - $23.50 based on experience.

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 We Love

• 1-3 years of experience in a similar role
• Experience with authorization or revenue cycle processes for physician/hospital administered medications, injections, infusions, or genetic testing is preferred
• Experience with infusion therapies and lifecycle management of the infusion authorization process
• Experience with oncology and specialty infusion therapies, treatment plans, and applying payor specific rules/policies
• 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

Minimum Education

High School Diploma/GED

Preferred: 2 Year/ Associates Degree

Certifications

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

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.

Benefits

• 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.
• 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.

Equality and Diversity

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.

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.

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.