Senior Bedded Insurance Authorization Specialist

🔥 21 hours ago

🇺🇸 United States – Remote

💵 $18 - $25 / hour

⏰ Full Time

🟠 Senior

🔒 Insurance

👻 Ghost score 1%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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 hospital-admitted patients • Conduct staff training and onboarding • Perform quality audits • Complete unbilled cleanup and reduction • Process pre-bill denials and P2P activities • Confirm active health insurance coverage and procedure coverage • Verify and document insurance eligibility and benefits • Review and submit clinical documentation supporting medical necessity • Obtain and maintain initial and subsequent insurance authorizations • Review visit data and payer-specific criteria to determine authorization needs • Follow up timely on authorization requests • Achieve greater than 95% accuracy, quality, and productivity while assisting with and monitoring Specialist assignments • Conduct quality audits and training sessions for new hires and seasoned associates • Assist leaders with team engagement and performance • Maintain regulatory compliance and provide age-appropriate care-related support

🎯 Requirements

• 2 years of customer service experience • 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 • Solid verbal and written communication skills • Ability to handle 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 • High School Diploma/GED required • CRCR required within 6 months of hire • Must reside in and be authorized to work within the United States

🏖️ Benefits

• Bonus incentives • Paid certifications • Tuition reimbursement • Comprehensive benefits, including healthcare, time off, retirement, and well-being programs • Career advancement opportunities • Professional development • Quarterly and annual incentive programs • Remote work • Company-paid CRCR certification within 6 months of hire