Senior Insurance Authorization Specialist - Infusion

Ensemble Health Partners•Work at Home - Ohio - Other, OH

3d•$19 - $24•Remote

About The Position

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.

Requirements

1-3 years of experience in a similar role
High School Diploma/GED Required
Certified Revenue Cycle Representative (CRCR) required within 9 months of hire -Company Paid
Must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require
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
Must reside and be authorized to work within the United States.

Nice To Haves

Experience with authorization or revenue cycle processes for physician/hospital administered medications, injections, infusions, or genetic testing is preferred
Experience with infusion therapies and lifecycle management of the infusion authorization process
Experience with oncology and specialty infusion therapies, treatment plans, and applying payor specific rules/policies
2 Year/ Associates Degree

Responsibilities

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.
Identify the appropriate clinical records and submit the authorization request to the insurance company based on plan requirements for approval.
Serve as 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.