Insurance Authorization Specialist

The Opportunity:

THE CAREER POTENTIAL 

There is no limit to the experiences, opportunities, and new directions you will have access to here at Ensemble Health Partners. More importantly, you will be driving the surge in a whole new direction in healthcare. That’s something we can all take pride in as we take this journey together.  

Ensemble Health Partners are a leading innovator in revenue cycle management and have been awarded the 2022 “Best in KLAS” designation for full revenue cycle outsourcing for the third year in a row, receiving the highest score in Ensemble’s history. This designation recognizes that out of all the companies reviewed that offer full revenue cycle outsourcing, Ensemble was ranked number one by healthcare leaders around the country for its excellence in improving financial outcomes and patient experiences 

THE OPPORTUNITY 

The Insurance Authorization Specialist I is responsible for performing insurance authorization for all patients scheduled for services. Insurance Authorization Specialist I will work within the policies and processes as they are being performed across the entire organization. 

Essential Job Objectives: 

• The Insurance Authorization Specialist is responsible for selecting accurate medical records for patient safety and working with insurance companies and/or physician offices to complete insurance authorization requirements to secure payment.  

• 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 any and all requirements to secure approval are identified and communicated. 

Experience We Love: 

• Knowledge of appeals concepts and principles 

• Advanced knowledge of medical coding and billing systems, documentation, and regulatory requirements 

• Ability to use independent judgement and to manage and impart confidential information 

• Ability to analyze 

• Strong written communication and interpersonal skills 

• Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation  

• Knowledge of current and developing issues and trends in medical coding procedures requirements 

• Ability to clearly communicate medical information to professional practitioners and/or the general public 

• Ability to adapt and modify medical billing procedures, protocol, and data management systems to meet specific operating requirements 

• Ability to provide guidance and training to professional and technical staff in area of expertise.   

• Ability to flex work schedule on an as needed basis to meet the business needs. 

Education/Certification(s): 

• High School Diploma Required – Associates Preferred  

• 2 years’ experience in a healthcare related position required.  

• Experience working with insurance companies and/or pre-authorizations required.   

• Certification Medical Assisting preferred.  

• Understanding of admission, billing, payments and denials.    

• Comprehensive knowledge of patient insurance process for obtaining authorizations and benefits verification.    

• Knowledge of medical terminology or CPT or procedure codes.  

• Patient Access experience with managed care/insurance and Call Center experience highly preferred.  

• Articulate, personable, dependable and confident with excellent communication skills.  

• Customer service oriented, builds trust and respect by exceeding customer expectations 

The #EnsembleDifference speaks for itself: 

• Three-time winner of “Best in Klas” 2020-2022 

• Top Workplace USA Award (Nationally 2022) 

• Top Workplace Innovation Award (Nationally 2022) 

• Top Workplace Work-Life Flexibility Award (Nationally 2022) 

• Top Workplace Leadership Award (Nationally 2022) 

• Top Workplace Purpose and Values Award (Nationally 2022) 

Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include: 

• Competitive compensation and benefits packages that reflect our commitment to providing fair and just workplaces.  

• Wellness programming is designed to help our associates enhance their health, including a comprehensive annual health risk assessment.  

• A culture truly participatory and to strengthen diversity and inclusion.  

• Growth - Once you've joined our team, you will discover a variety of traditional and online learning opportunities, including tuition reimbursement, to help you acquire new skills and obtain degrees, certifications and CEUs. And our managers will coach you toward greater success.  

• Recognition - We recognize our associates through programs that include service awards, celebrations, and personal appreciation. We also survey associates annually to assess their satisfaction with our organization and managers, and to identify areas for improvement. 

Ensemble Health Partners 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 our Human Resources Department at 877-692-7780 or Recruitment@ensemblehp.com.  This department will make sure you get connected to a Human Resources representative that can assist you. 

Learn more about Ensemble here