Senior Insurance Authorization Specialist - Infusion

Ensemble Health Partners; United States; Remote; USD 26,000 - 32,000; Full time

Benefits offered by this job

Healthcare benefits

Tuition reimbursement

Professional development

Job summary

Ensemble Health Partners is seeking a Senior Insurance Authorization Specialist to support authorization and verification for patients, ensuring accurate records, eligibility, and timely approvals. This remote role may require occasional onsite travel to client locations or corporate offices as business needs dictate.

You will mentor teammates, handle escalations, and maintain high quality standards while aligning with regulatory compliance and Ensemble's patient-centric mission.

Qualifications

• 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.
• 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.

Responsibilities

• Support the Insurance Authorization I staff in selecting accurate medical records and insurance information.
• Complete insurance authorization requirements to secure payment and ensure active coverage.
• Assist with escalated issues, tracking system issues, and training new hires.
• Identify appropriate clinical records and submit authorization requests to insurers.
• Liaise between ordering physicians and insurers to communicate requirements for approval.

Skills

1-3 years experience

Authorization/revenue cycle experience

Attention to detail

Willing to travel to client sites

Education

High School Diploma/GED

2 Year/ Associates Degree

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:

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
• 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

Minimum Education:

• High School Diploma/GED Required

Preferred:

• 2 Year/ Associates Degree2 Year/ Associates Degree

Certifications:

• 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.

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.

Employment Disclaimers – Ensemble