Senior Bedded Insurance Authorization Specialist

🔥 8 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟠 Senior

🔒 Insurance

👻 Ghost score 11%

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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 • Conduct staff training and onboarding • Perform quality audits • Complete unbilled authorization cleanup and reduction • Process pre-bill denials and P2P activities • Confirm patients’ health insurance is active and covers procedures • Verify and document insurance eligibility and benefits • Review and submit clinical documentation supporting diagnosis, treatment, services, and medical necessity • Obtain, verify, and maintain insurance authorizations • Ensure initial and subsequent authorizations are obtained timely • Review patient visit information and payer-specific criteria to determine authorization needs • Review visit data for accurate clinical information and follow up on authorization securement • Achieve over 95% accuracy, quality, and productivity while assisting with and monitoring Specialist assignments • Conduct quality audits and training sessions for new hires and seasoned associates • Perform daily unbilled authorization follow-up and reduction and pre-bill denials and P2P processing • Assist leaders with team engagement and performance • Provide age-appropriate care-related support in accordance with departmental policies and procedures

🎯 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 • Ability to retain material quickly • Positive demeanor and solid verbal and written communication skills • Professional appearance and approach • 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 • Ability to successfully complete additional job-related requirements • 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

• Comprehensive benefits package including healthcare, time off, retirement, and well-being programs • Professional development investment • Professional certification relevant to the associate’s field • Tuition reimbursement • Quarterly and annual incentive programs • Company-paid CRCR certification within 6 months of hire • Work-life flexibility • Remote work