Bedded Insurance Authorization Specialist

🔥 18 minutes ago

🇺🇸 United States – Remote

💵 $17 - $18 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔒 Insurance

👻 Ghost score 1%

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Ensemble Health Partners

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

💼 Consulting

🛡️ Insurance

📦 Logistics

💰 Private Equity Round on 2022-03

Consulting • Insurance • Logistics

Ensemble Health Partners is a leading provider of revenue cycle management (RCM) services for healthcare organizations. They offer an end-to-end RCM solution that helps hospitals, health systems, and affiliated physician groups optimize their revenue cycles, reduce denials and underpayments, and enhance patient experiences using a combination of expert management and advanced technology. Ensemble Health Partners leverages certified operators and AI to deliver consistent results, improve collections, and support future growth for healthcare providers. They are recognized for their robust client partnerships and commitment to delivering reliable revenue lift and cost savings for their clients.

📋 Description

• Perform initial and concurrent insurance authorization securement, clinical submission, and denial prevention for patients admitted to hospitals • Confirm patients’ health insurance is active and covers procedures • Confirm covered benefits, policy effective dates, coverage limitations, requirements, and patient liabilities • Check deductible, coinsurance, and copayment amounts and notify patients of amounts due when applicable • Verify and document insurance eligibility and benefits • Review and submit clinical documentation to support treatment appropriateness and medical necessity • Obtain, verify, and maintain insurance authorizations for designated patients • Ensure initial and subsequent authorizations are obtained timely • Reduce and eliminate authorization denials • Review patient visit information and payer-specific criteria to determine authorization needs • Ensure services are within benefit plans and use appropriate contracted providers • Review visit data for accurate payer submissions and timely follow-up • Achieve greater than 95% accuracy/quality and productivity

🎯 Requirements

• Experience working with insurance companies and/or medical authorizations • Comprehensive understanding of insurance authorization requirements, contract benefits, CPT codes, and medical terminology • High level of critical thinking and problem-solving skills • Ability to retain material quickly • Positive demeanor and solid verbal and written communication skills • Ability to handle considerably stressful situations and multiple tasks simultaneously • Working knowledge of personal computers and standard office equipment • Ability to access online insurance eligibility and pre-certification systems • Ability to successfully complete additional job-related training • Knowledge and skills necessary to provide care appropriate to the age of patients served • Knowledge of growth and development principles across the life span • High School Diploma or GED • Certified Revenue Cycle Representative (CRCR) required within 9 months of hire; company paid • Hospital experience preferred • 2 Year/Associates Degree in Medical Assisting or Practical Nursing preferred

🏖️ Benefits

• Remote Work • Bonus Incentives • Paid Certifications • Tuition Reimbursement • Comprehensive Benefits, including healthcare, time off, retirement, and well-being programs • Career Advancement • Professional certification relevant to the field • Quarterly and annual incentive programs • Reasonable accommodations for qualified individuals with disabilities