Medical Records and Authorization Specialist

3 weeks ago


Houston, United States Baxter Full time

This is where you save and sustain lives

At Baxter, we are deeply connected by our mission. No matter your role at Baxter, your work makes a positive impact on people around the world. You’ll feel a sense of purpose throughout the organization, as we know our work improves outcomes for millions of patients. 

Baxter’s products and therapies are found in almost every hospital worldwide, in clinics and in the home. For over 85 years, we have pioneered significant medical innovations that transform healthcare.

Together, we create a place where we are happy, successful and inspire each other. This is where you can do your best work. 

Join us at the intersection of saving and sustaining lives— where your purpose accelerates our mission. 

Your role at Baxter

THIS IS WHERE you build trust to achieve results…

As the Medical Records and Authorization Specialist, you will be responsible for documentation collection and review, prior authorization, and reauthorization submissions. The Medical Records and Authorization Specialist communicates directly with client medical records depts, patients, healthcare teams, sales teams, and insurance companies as well as collaborating cross-functionally with other Cardiology Health teams to coordinate in our mission of Saving and Sustaining Lives.

What you'll be doing

Ensure coverage and payer requirements.

Gather clinical documentation to support medical necessity for Cardiology devices.

Establish and maintain positive partnerships with sales team and healthcare teams.

Review and assess clinical documentation to ensure all applicable coverage criteria requirements are met.

Prepare and submit prior authorization initial and renewal requests to all insurance companies including.

Process authorization decisions from payers timely to streamline and drive revenue.

Identify payer trends and establish payer-specific strategies to overcome reimbursement challenges.

Provide superior customer experience by leveraging ability to discuss payer policies, coverage criteria, or any pertinent product information with patients and healthcare teams.

Understand and adhere to all policies for Baxter and 3rd party payers to ensure the highest standards of quality and compliance.

Consistently contribute to team goals and understand how they support greater organizational goals.

Actively seek additional experience and knowledge across all functional areas to gain expertise.

Provide workload coverage as needed.

Perform other duties and projects as assigned.

What you'll bring

3+ years of experience in medical records, authorization and health insurance within industry required.

Knowledge of Federal, State, and Local regulations, guidelines, and standards, including a working knowledge of HIPAA rules and regulations.

Third party payer experience strongly preferred.

Experience in reviewing medical records and obtaining third-party payer reimbursement.

Exceptional written, verbal, and interpersonal communications.

Strong critical thinking and problem-solving skills.

Detail orientated and ability to multi-task.

Ability to work independently as well as in a team environment.

Possess the ability to manage time and prioritize critical priorities.

Proficiency in Microsoft Office Software.

# LI-DF1

Baxter is committed to supporting the needs for flexibility in the workplace. We do so through our flexible workplace policy which includes a minimum of 3 days a week onsite. This policy provides the benefits of connecting and collaborating in-person in support of our Mission.



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