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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. 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.

Ensemble Health Partners

Senior Insurance Authorization Specialist - Infusion

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The position works closely with business data stewards, data engineering teams, and key stakeholders to translate governance requirements into reliable, reusable technical solutions and self-service capabilities for governed data assets. The ideal candidate pairs strong hands-on programming ability with practical knowledge of data governance and cataloging tools to deliver scalable, efficient solutions that foster a culture of data stewardship and operational excellence.

Solution Engineer, Data Governance

Demonstrates knowledge of the principles of growth and development of the life span and possesses the ability to assess data reflective of the patient's status and interprets the appropriate information needed to identify each patient's requirements relative to his or her age, specific needs and to provide the care needed as described in departmental policies and procedures. The Bedded Insurance Authorization Senior Specialist is responsible for performing initial and concurrent insurance authorization securement, clinical submission and denial prevention for all patients admitted to the hospital for clients.

Senior Bedded Insurance Authorization Specialist

The consultant partners with senior leaders, HR business partners, Operations, SG&A functions, Compensation, and Organizational Effectiveness to conduct discovery, evaluate spans and layers, clarify work and accountabilities, and create iterative organization models and charts. The Temporary HR Consultant, Organizational Design is a six-month consulting assignment focused on assessing current organizational structures and developing practical future-state design options.

HR Consultant

Maintains a schedule of key update dates for expected reimbursement rules, such as Medicare OP quarterly updates, yearly Diagnostic Related Group (DRG) updates, and yearly increases for the Managed Care contracts utilizing such tools as a Smartsheet for tracking. The Contract Management Technician will actively participate with the Contract Management knowledge share opportunities to expand their knowledge base and role along with assisting in expanding the knowledge of their peers by assisting with training and other knowledge share opportunities.

Contract Management Technician

The DRG Senior Coding Educator acts as a subject matter expert to educate, train, and develop/revise processes in coordination with leadership to assist in achieving CDI’s goal of facilitating accurate and complete documentation for coding and the capture of severity, acuity, and risk of mortality and most accurate Diagnosis Related Group (DRG) assignments. Collaborate with CDI leadership and other clinicians to facilitate the ongoing relevance of department specific orientation content, educational materials, and training programs/resources.

DRG Senior Educator, Coding

Ability to assess and identify appropriate resources, internal and community, on assigned caseload, and to work collaboratively with health care team, providers, and payors to achieve the desired patient, quality, and financial outcomes. By embodying our core purpose of customer obsession, new ideas, and driving innovation, and delivering excellence, you will help ensure that every touchpoint is meaningful and contributes to our mission of redefining the possible in healthcare.

RN, Senior Utilization Review Quality

Contributes to the achievement of clinical excellence; quality ratings improvement, appropriate inpatient and outpatient utilization, affordability, compliance, growth and focused improvement, and that initiatives are consistently implemented and successfully executed to achieve goals. Recommends changes and enhancements to current managed care, review guidelines, and clinical criteria based on clinical knowledge of health care delivery systems, utilization methods, reimbursement methods and treatment protocols.

Medical Mutual

Assistant Medical Director

Remain abreast of current requirements of the Centers for Medicare & Medicaid Services, (CMS) to include National Coverage Determinations, (NCD) and Local Coverage Determinations, (LCD) guidelines, related to the assignment of modifiers, to ensure the submission of a clean claim the first time through. Attends required system, hospital and departmental meetings and educational sessions as established by leadership, as well as completion of required annual learning programs, to ensure continued education and growth.

Medical Coding Specialist

Technical Program Management - Independently leads a portfolio of complex, cross-functional technology initiatives from strategy and intake through release, production stabilization, and outcome realization; establishes program governance and owns roadmaps, scope, schedules, resources, risks, dependencies, change control, executive communication, and delivery tradeo. This role independently leads programs across multiple clients, platforms, engineering teams, and operational workstreams from intake through production readiness and stabilization, with accountability for technical roadmaps, scope, schedules, releases, risks, dependencies, change control, governance, and delivery outcomes.

Senior Technical Program Manager

Agility core practices, Agility core practices, Agreements and negotiations, Analytical Thinking, Business Acumen, Commercial Acumen, Communication, Continuous Improvement, Continuous Learning, Creativity and Innovation, customer and competitor understanding, Customer centric thinking, Customer data knowledge, Data Analysis, Data visualization and interpretation, Decision Making, Digital Collaboration, Digital Fluency, Industry knowledge and advocacy, Integrated pricing, Knowledge Sharing, Leading transformation, market, Negotiation planning and preparation, Offer and product knowledge {+ 13 more} . This position works as part of a traveling field team responsible for completing store resets, reflows, cooler resets and refreshes, remodel support, fixture changes, planogram implementation, promotional execution, backroom and storage organization, and other merchandising projects.

Field Merchandiser

Cengage, a global education technology company serving millions of learners, provides affordable, quality digital products and services that equip students with the skills and competencies needed to be job ready. Build and manage a robust pipeline of high-value opportunities through proactive prospecting (cold outreach, executive engagement, networking, and industry events).

Cengage Learning

Enterprise Client Executive (Infosec) (Remote)

The base salary for this position is reflective of the range of salary levels for all roles within this pay grade across the U.S. Individual salaries within this range will vary based on factors such as role, relevant skillset, relevant experience, education and geographic location. The leader will design, lead, and implement analytics, technology, and process improvement decisions focused on digital account controls and other channels for new account originations to drive profitability while mitigating fraud risk.

Fifth Third Bank

Senior Quantitative Manager (New Account Screening)

Using company-provided equipment and our Talkdesk application, you'll handle inbound customer calls and provide friendly, professional service while addressing post-sale related questions and concerns. Whether it's tracking a package, returning an item, answering warranty questions, or finding the right automotive part, you'll help customers find the answers and solutions they need.

Summit Racing

Remote Customer Service Representative

Demonstrates knowledge of the principles of growth and development of the life span and possesses the ability to assess data reflective of the patient's status and interprets the appropriate information needed to identify each patient's requirements relative to his or her age, specific needs and to provide the care needed as described in departmental policies and procedures. Ability to assess and identify appropriate resources, internal and community, on assigned caseload, and to work collaboratively with health care team, providers, and payors to achieve the desired patient, quality, and financial outcomes.

Utilization Review RN

By embodying our core purpose of customer obsession, new ideas, and driving innovation, and delivering excellence, you will help ensure that every touchpoint is meaningful and contributes to our mission of redefining the possible in healthcare. Ensure client invoicing and accrual data is completed accurately, on schedule, and within the defined scope, while promptly communicating any barriers, risks, or delays to the appropriate stakeholders.

Financial Operations Associate Analyst

14 - $14 an hour Starting pay - $14/hr plus shift differential(extra $1/hr nights & wkds) Working hours- 10:00am-8:00pm (EST); Work Days- M-F Paid Training - typically 1-2 weeks in length from 9:00am-6:00pm Mon-Fri (EST) Status- Full Time 40 hours, Benefit eligible 1st of month after 60 days Five Star Solutions values diversity and is committed to cultivating a professional, diverse workforce by hiring the best people available and providing the best service possible to our customers. This role is responsible for handling inbound and outbound calls, responding to text messages and emails, managing case work, documenting interactions accurately, and ensuring a positive customer experience.

HOUR

Five Star Solutions

Member Support Specialist

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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. Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups.

Insurance Authorization Specialist

Bonus Points if you have: 1+ years of experience in related fieldBenefits you might not have expectedEmployee Assistance Program CounselorsDiscover Care@Work Family Assistance Program (Discounted childcare at participating centers, free care.com membership, and subsidized Backup Care Services)Perks at Work (access discounts from over 30,000 merchants, earning WOW Points while you shop)Opportunities to volunteer in the communityDevelopment groups and trainingIf you do choose to work onsite, we have a f ull service cafeteria featuring Starbucksand subsidized m indful options, as well as access to our Fitness Center. Starting DAY ONE (yes, you heard that correctly NO WAITING PERIOD), you can take advantage of our amazing benefit package, designed with you and your future in mind!

Jobsultant Solutions

Inbound Customer Service (Remote)

Leadership Decision Making - Makes day-to-day leadership decisions by securing and comparing information from multiple sources to identify issues; commits to an action after weighing alternative solutions against important criteria; effectively communicates decisions to the appropriate people and teams and holds them accountable. Coaching & Building Talent - Achieves results through other leaders by empowering them and providing feedback, instruction and development (coaching the coach) to develop their own associates; plans and supports the growth of individual skills and abilities in preparation for their next role (building bench); focuses on retention of high performers.

Work From Home Jobs in Newark, OH

Senior Insurance Authorization Specialist - Infusion Ensemble Health Partners

Solution Engineer, Data Governance Ensemble Health Partners

Senior Bedded Insurance Authorization Specialist Ensemble Health Partners

HR Consultant Ensemble Health Partners

Contract Management Technician Ensemble Health Partners

DRG Senior Educator, Coding Ensemble Health Partners

RN, Senior Utilization Review Quality Ensemble Health Partners

Assistant Medical Director Medical Mutual

Medical Coding Specialist Ensemble Health Partners

Senior Technical Program Manager Ensemble Health Partners

Field Merchandiser BP

Enterprise Client Executive (Infosec) (Remote) Cengage Learning

Senior Quantitative Manager (New Account Screening) Fifth Third Bank

Remote Customer Service Representative Summit Racing

Utilization Review RN Ensemble Health Partners

Financial Operations Associate Analyst Ensemble Health Partners

Member Support Specialist Five Star Solutions

Insurance Authorization Specialist Ensemble Health Partners

Inbound Customer Service (Remote) Jobsultant Solutions

Physician Advisor Ensemble Health Partners

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