Senior Bedded Insurance Authorization Specialist

Ensemble Health Partners

. Perform initial and concurrent insurance authorization securement, clinical submission, and denial prevention for patients admitted to hospitals .

Posted 10/14/2026full-timeRemote • United StatesSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in insurance authorization processes, including verification of eligibility, clinical documentation, and denial prevention. Proficient in conducting training, quality audits, and maintaining high accuracy and productivity in a fast-paced environment.

Highest-signal resume keywords

Insurance AuthorizationCPT CodesMedical TerminologyCRCR CertificationCustomer Service Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Insurance Eligibility VerificationClinical Documentation ReviewDenial PreventionQuality AuditsPre-Bill Denial ProcessingP2P ActivitiesAuthorization SecurementContract Benefits UnderstandingCritical ThinkingProblem-Solving

Soft Skills

Verbal CommunicationWritten CommunicationPositive DemeanorStress ManagementMulti-Tasking

Tools & Technologies

Online Insurance Eligibility SystemsPre-Certification SystemsStandard Office EquipmentPersonal Computers

Certifications & Qualifications

CRCR

Industry Keywords

Insurance CompaniesMedical AuthorizationsPatient CareHealthcare ComplianceAuthorization Requirements

About the role

Key responsibilities & impact

Perform initial and concurrent insurance authorization securement, clinical submission, and denial prevention for patients admitted to hospitals
Conduct staff training and onboarding
Perform quality audits
Complete unbilled authorization cleanup and reduction
Process pre-bill denials and P2P activities
Confirm patients’ health insurance is active and covers procedures
Verify and document insurance eligibility and benefits
Review and submit clinical documentation supporting diagnosis, treatment, services, and medical necessity
Obtain, verify, and maintain insurance authorizations
Ensure initial and subsequent authorizations are obtained timely
Review patient visit information and payer-specific criteria to determine authorization needs
Review visit data for accurate clinical information and follow up on authorization securement
Achieve over 95% accuracy, quality, and productivity while assisting with and monitoring Specialist assignments
Conduct quality audits and training sessions for new hires and seasoned associates
Perform daily unbilled authorization follow-up and reduction and pre-bill denials and P2P processing
Assist leaders with team engagement and performance
Provide age-appropriate care-related support in accordance with departmental policies and procedures

Requirements

What you’ll need

2 years of customer service experience
Experience working with insurance companies and/or medical authorizations
Comprehensive understanding of insurance authorization requirements, contract benefits, CPT codes, and medical terminology
High level of critical thinking and problem-solving skills
Ability to retain material quickly
Positive demeanor and solid verbal and written communication skills
Professional appearance and approach
Ability to handle stressful situations and multiple tasks simultaneously
Working knowledge of personal computers and standard office equipment
Ability to access online insurance eligibility and pre-certification systems
Ability to successfully complete additional job-related requirements
High School Diploma/GED required
CRCR required within 6 months of hire
Must reside in and be authorized to work within the United States

Benefits

Comp & perks

Comprehensive benefits package including healthcare, time off, retirement, and well-being programs
Professional development investment
Professional certification relevant to the associate’s field
Tuition reimbursement
Quarterly and annual incentive programs
Company-paid CRCR certification within 6 months of hire
Work-life flexibility
Remote work