[Hiring] Insurance Authorization Specialist @Ensemble Health Partners

Role Description

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

• Select accurate medical records for patient safety.
• Work 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.
• Act as the liaison between the ordering physician and insurance company to ensure all requirements to secure approval are identified and communicated.

Qualifications

• Knowledge of appeals concepts and principles.
• Advanced knowledge of medical coding and billing systems, documentation, and regulatory requirements.
• Ability to use independent judgment and manage 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 business needs.
• 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.

Requirements

• High school diploma or GED.
• 2+ years of Insurance Authorization experience.
• Certification: Certified Revenue Cycle Representative (CRCR) required within 9 months of hire - Company Paid.

Benefits

• Bonus Incentives.
• Paid Certifications.
• Tuition Reimbursement.
• Comprehensive Benefits.
• Career Advancement.
• This position pays between $17.00 - $18.65/hr based on experience.