Insurance Specialist

Schedule: Varied with Saturday Rotation - 20hrs

At Children's, the region's only full-service pediatric healthcare center, our people make us the very best for kids. Come cultivate your passion, purpose and professional development in an environment of excellence and inclusion, where team members are supported and deeply valued. Opportunities for career growth abound as we grow our services and spaces, including the cutting-edge Hubbard Center for Children. Join our highly engaged, caring team—and join us in providing brighter, healthier tomorrows for the children we serve. Children's is committed to diversity and inclusion. We are an equal opportunity employer including veterans and people with disabilities.

A Brief Overview

The Insurance Specialist is a behind-the-scenes expert in patient registration, ensuring the accuracy and completeness of insurance, guarantor, and guardianship information. This role is responsible for pre-registering all scheduled encounters across the enterprise and providing virtual/remote registration support for on-demand needs. By maintaining thorough and accurate patient records, the Insurance Specialist plays a critical role in facilitating a seamless financial and administrative experience for patients and the organization.

Essential Functions

• Patient Registration & Pre-Registration
• Complete full patient pre-registration for all scheduled encounters across the enterprise, ensuring demographic accuracy, insurance verification, and guardianship determination.
• Maintain accurate guarantor and financial responsibility records in the electronic health record (EHR) system.
• Secure complete and accurate insurance details, identifying potential coverage issues before the patient arrives for care.
• Address work queues (WQs) and in-basket messages related to patient registration and insurance updates.
• Insurance & Guarantor Management
• Verify patient insurance coverage, benefits, and eligibility through payer portals and internal systems.
• Identify and resolve discrepancies in insurance information before services are rendered to prevent billing issues.
• Determine and update guarantor and guardianship status, ensuring compliance with hospital policies and regulatory standards.
• Virtual & Remote Registration Support
• Provide real-time registration support for virtual and remote patient encounters, ensuring a seamless experience for both patients and clinical teams.
• Respond to urgent registration needs for on-demand services, including walk-in, inpatient and emergency encounters when applicable.
• Collaboration & Compliance
• Work closely with financial clearance teams to resolve insurance-related barriers to patient access.
• Maintain a high level of accuracy in patient records to ensure smooth downstream billing and reimbursement processes.
  Adhere to HIPAA and hospital policies regarding data security, patient privacy, and regulatory compliance.

Education Qualifications

• High School Diploma High school diploma or equivalent Preferred

Experience Qualifications

• Experience in patient registration, healthcare administration, or a similar role within a hospital or clinical setting. Preferred

Skills and Abilities

• Strong customer service and interpersonal skills, with a focus on patient-centered care.
• Ability to multitask and stay organized in a fast-paced, high-pressure environment.
• Detail-oriented, with a commitment to accuracy in documentation and patient information.
• Effective communication skills for interacting with patients, families, and healthcare teams.

Licenses and Certifications

• Primarily remote or back-office environment with minimal patient interaction.
  Standard business hours with flexibility for urgent registration support as needed.

Children's is the very best for kids and the very best for your career At Children's, we put YOU first so together, we can improve the life of every child