Senior Insurance Authorization Specialist - Infusion

Ensemble Health Partners; Ohio; Remote; USD 30,000 - 39,000; Full time

Benefits offered by this job

Healthcare

Tuition reimbursement

Job summary

Ensemble Health Partners is seeking a Senior Insurance Authorization Specialist to support insurance authorization and verification for patients. The role will mentor and assist the Insurance Authorization Specialists I and Verification Specialists I while ensuring 95% accuracy and high-quality customer service.

This is a remote position with potential travel to client sites or corporate offices as business needs require.

Qualifications

• High School Diploma/GED required.
• Experience with insurance authorization and revenue cycle processes preferred.
• Willing to travel to onsite locations as needed.

Responsibilities

• Support Insurance Authorization Specialists I and Verification Specialists I to ensure accuracy and workflow.
• Assist supervisor with escalated issues and training new hires.
• Identify and submit authorization requests to insurance companies based on plan requirements.
• Act as liaison between ordering physicians and insurers to secure approvals.
• Maintain high accuracy and quality in accounts and customer service etiquette.

Skills

Insurance verification

Customer service

Mentoring

Attention to detail

Education

High School Diploma

Tools

EMR systems

Job description

Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. 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. Customer Obsession: 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.

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.
• Experience with authorization or revenue cycle processes for physician/hospital administered medications, injections, infusions, or genetic testing is preferred
• Experience with oncology and specialty infusion therapies, treatment plans, and applying payor specific rules/policies
• 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

High School Diploma/GED Required

Awards & Recognition

• 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
• Monster Top Workplace for Remote Work 2024

Benefits

• 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.
• Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.

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. 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. 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 equity;