Insurance Authorization Specialist

Thank you for considering a career at Ensemble Health Partners!

Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.

Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference

The Opportunity:

***This job will be onsite and will be required to work at Bon Secours - St. Mary's Hospital - Richmond***

The Insurance Authorization Specialist performs insurance authorization 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 Insurance Authorization Specialist I will work within the policies and processes as they are being performed across the entire organization.

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Essential Job Functions:

• 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. This role will identify the appropriate clinical records and submit the authorization request to the insurance company based on plan requirements for approval. The Insurance Authorization Specialist I will be the liaison between the ordering physician and insurance company to ensure all requirements to secure approval are identified and communicated requirements to secure payment. This role will identify the appropriate clinical records and submit the authorization request to the insurance company based on plan requirements for approval.
• Among the expectations of this role, the Specialist will achieve>95% accuracy/quality while handling accounts >95% quality of expected customer service etiquette Meet or exceed Lower controls of average productivity amongst the Insurance Authorization Specialist I productivity standards
• Performs other duties as assigned

Requirements:

• 1 to 3 years’ experience in a healthcare setting. Experience working with insurance verification and authorization requirements.
• High School Diploma, GED, or Equivalent Experience

Experience We Love:

• Understanding of Revenue Cycle including admission, billing, payments and denials. Comprehensive knowledge of patient insurance process for obtaining authorizations and benefits verification. Knowledge of Health Insurance requirements. Knowledge of medical terminology or CPT or procedure codes.
• Patient Access experience with managed care/insurance, formal typist with a minimum of 35 WPM, intermediate proficiency in MS applications (Word, Excel & PowerPoint), experience with multiple computer systems and use of dual screens. Able to multitask and work individually while applying critical thinking skills. Customer Service experience highly preferred.

Join an award-winning company

Three-time winner of “Best in KLAS” 2020-2022

2022 Top Workplaces Healthcare Industry Award

2022 Top Workplaces USA Award

2022 Top Workplaces Culture Excellence Awards

• Innovation

• Work-Life Flexibility

• Leadership

• Purpose + Values

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

• Associate Benefits –  We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs. 

• Our Culture – Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.

• Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement. 

• Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company. 

Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.

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 [email protected].

This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role’s range.

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