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Insurance Verification Specialist 2
2 months ago
The Insurance Verification Specialist 2 plays a crucial role in ensuring timely verification of insurance benefits and financial clearance for patients, physicians, and internal hospital personnel at Baylor Scott & White Health. This position has a direct impact on the organization's reimbursement from payers for patient accounts that are scheduled and unscheduled.
Key Responsibilities- Verify insurance eligibility and benefits to ensure financial clearance of patient accounts.
- Complete payor forms related to notification and authorization.
- Coordinate the submission of clinical documentation from physicians to payers for authorization needs.
- Calculate accurate patient financial responsibility.
- Communicate effectively with Utilization Review, and partner with physician and facility staff to ensure financial clearance of the patient's account prior to scheduled or unscheduled service during the patient's hospital stay.
- Interpret complex payer coverage information, including network participation status with providers, limited plan coverage, and inactive benefits.
- Assist co-workers and facility customers with complex questions and issues.
- Document systems according to Insurance Verification guidelines to ensure accurate and timely reimbursement.
- Manage workflow of specific areas to ensure maximum results for the department.
- 2 years of healthcare or customer service experience or education equivalency required.
- Ability to consistently meet performance standards of production, accuracy, completeness, and quality.
- Knowledge of payer guidelines by plan and service type.
- Excellent listening and communication skills, and professional telephone etiquette.
- Ability to maintain a professional demeanor in a highly stressful and emotional environment, including behavioral health and life-or-death situations.
- High level of empathy and ability to effectively communicate with patients and family members during traumatic events.
- 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.
- Immediate eligibility for health and welfare benefits.
- 401(k) savings plan with dollar-for-dollar match up to 5%.
- Tuition Reimbursement.
- PTO accrual beginning Day 1.
