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Insurance Verification Specialist (Remote)

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Baylor Scott & White Health

9d ago

  • Job
    Full-time
    Entry & Junior Level
  • Customer Relations
    Healthcare
  • Dallas

AI generated summary

  • You need 1 year of healthcare or customer service experience, strong communication skills, empathy, data entry skills, and a high school diploma. Must handle stress well and adapt to changing priorities.
  • You will verify insurance eligibility, complete authorization forms, coordinate clinical documentation, calculate financial responsibility, collaborate with staff, interpret coverage, and document processes for reimbursement.

Requirements

  • 1 Year Of Healthcare Or Customer Service Experience Preferred.
  • Must have the ability to consistently meet performance standards of production, accuracy, completeness and quality.
  • Ability to understand and adhere to payer guidelines by plan and service type.
  • Requires good listening, interpersonal and communication skills, and professional, pleasant and respectful telephone etiquette.
  • Ability to maintain a professional demeanor in a highly stressful and emotional environment, behavioral health and/or suffering patients in addition to life or death situations.
  • Must be able to exhibit a high level of empathy with the ability to effectively communicate with patients and family members during traumatic events, while demonstrating exceptional customer service skills.
  • Demonstrates ability to manage multiple, changing priorities in an effective and organized manner.
  • Excellent data entry, numeric, typing and computer navigational skills. Basic computer skills and Microsoft Office.
  • EDUCATION - H.S. Diploma/GED Equivalent
  • EXPERIENCE - Less than 1 Year of Experience

Responsibilities

  • Performs financial clearance of patient accounts by verifying insurance eligibility and benefits and ensuring all notifications and authorizations are completed within the required timeframe.
  • Completes appropriate payor forms related to notification and authorization.
  • Coordinates the submission of clinical documentation from physicians to payers for authorization needs.
  • Calculates accurate patient financial responsibility.
  • Communicates timely with Utilization Review, and collaborates effectively with physician and facility staff to ensure financial clearance of the patients account prior to scheduled or unscheduled service during the patient’s hospital stay.
  • Interprets complex payer coverage information including, but not limited to, network participation status with provider, limited plan coverage and inactive benefits.
  • Documents systems according to the Insurance Verification guidelines to assure accurate and timely reimbursement.

FAQs

What is the primary responsibility of an Insurance Verification Specialist?

The primary responsibility of an Insurance Verification Specialist is to provide patients, physicians, and internal hospital personnel with insurance benefit information, ensuring timely verification of insurance benefits and financial clearance for patient accounts.

What kind of experience is preferred for this role?

The role prefers candidates with 1 year of healthcare or customer service experience.

What qualifications are required for this position?

The minimum qualifications include a high school diploma or GED equivalent, and less than 1 year of experience.

What skills are essential for success in this position?

Essential skills include good listening, interpersonal and communication abilities, empathy, organization, and excellent data entry, numeric, typing, and computer navigational skills.

Is there a requirement for knowledge of payer guidelines?

Yes, candidates must have the ability to understand and adhere to payer guidelines by plan and service type.

What kind of work environment is expected for this role?

The work environment can be highly stressful and emotionally charged, dealing with behavioral health and patients in life or death situations, requiring a professional demeanor.

What does the benefits package include for this role?

The benefits package includes immediate eligibility for health and welfare benefits, a 401(k) savings plan with a dollar-for-dollar match up to 5%, tuition reimbursement, and PTO accrual beginning on Day 1.

How is financial clearance of patient accounts performed?

Financial clearance is performed by verifying insurance eligibility and benefits, completing payor forms, coordinating clinical documentation submissions for authorizations, and calculating accurate patient financial responsibility.

How important is communication in this role?

Communication is very important; the specialist must communicate timely with Utilization Review and collaborate effectively with staff to ensure financial clearance before patient services.

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Baylor Scott & White Health

Changing Healthcare for the Better.

Science & Healthcare
Industry
10,001+
Employees
1903
Founded Year

Mission & Purpose

As the largest not-for-profit health system in the state of Texas, Baylor Scott & White promotes the health and well-being of every individual, family and community it serves. It is committed to making quality care more accessible, convenient and affordable through its integrated delivery network, which includes the Baylor Scott & White Health Plan, Baylor Scott & White Research Institute, the Baylor Scott & White Quality Alliance and its leading digital health platform – MyBSWHealth. Through 51 hospitals and more than 1,100 access points, including flagship academic medical centers in Dallas, Fort Worth and Temple, the system offers the full continuum of care, from primary to award-winning specialty care. Founded as a Christian ministry of healing more than a century ago, Baylor Scott & White today serves more than three million Texans. For more information, visit: BSWHealth.com.

Culture & Values

  • We serve faithfully

  • We never settle

  • We are in it together

  • We make an impact