Senior Insurance Authorization Specialist

The Senior Insurance Authorization Specialist is responsible for supporting the Insurance Authorization Specialist I and Insurance Verification Specialists I while performing insurance authorization and verification for all patients scheduled for services at Ensemble Health Partners. They are responsible for performing these functions while meeting the mission of Ensemble Health Partners and all regulatory compliance requirements. The Senior Insurance Authorization Specialist will work within the policies and processes as they are being performed across the entire organization. They'll support the Department's Supervisor with the daily workflow and distribution of workload, answer questions as the assigned subject matter experts, assist with mentoring and training new members of the team and report any system or process issues identified.

This position pays between $18.65 - $23.50 based on experience

Job Responsibilities:

• The Senior Insurance Authorization Specialist will support the Insurance Authorization I staff in their responsibility for selecting accurate medical records for patient safety, obtaining and validating demographic and insurance information, working with insurance companies and/or physician offices to complete insurance authorization requirements to secure payment, and ensure active/eligible coverage.

• Assist the supervisor of the department with escalated issues, tracking system and process issues as well as assisting in the training and mentoring of new hires. Among the expectations of this role the Senior Insurance Authorization Specialist will assist the Insurance Authorization Specialists I and Insurance Verification Specialists I in achieving: >95% accuracy/quality while handling accounts, as measured by account audits >95% quality of expected customer service etiquette, as measured by phone call audits Meet or exceed Lower controls of average productivity amongst the team productivity standards.
• Assist the supervisor of the department with escalated issues, tracking system and process issues as well as assisting in the training and mentoring of new hires.

• 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 all requirements to secure approval are identified and communicated.

Performs other duties as assigned.

Experience We Love:

• 1-3 years of experience in a similiar role
• 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
• This is a remote position; however, candidates must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require
• Experience with authorization or revenue cycle processes for physician-administered medications, injections, infusions, or genetic testing is preferred

Minimum Education:

• High School Diploma/GED Required

Preferred:

• 2 Year/ Associates Degree2 Year/ Associates Degree

Certifications:

• Certified Revenue Cycle Representative (CRCR) required within 9 months of hire -Company Paid