Access Services Insurance Verification Specialist - Days - Hybrid at Baylor Scott & White Health

Dallas, Texas, United States -

Full Time

Start Date

Immediate

Expiry Date

06 Mar, 26

Salary

0.0

Posted On

06 Dec, 25

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Insurance Verification, Financial Clearance, Customer Service, Communication Skills, Data Entry, Interpersonal Skills, Empathy, Organizational Skills, Microsoft Office, Payer Guidelines, Documentation, Clinical Coordination, Patient Interaction, Problem Solving, Attention to Detail, Stress Management

Industry

Hospitals and Health Care

Description

JOB SUMMARY The Insurance Verification Specialist 1, under general supervision, provides patients, physicians and internal hospital personnel with insurance benefit information. This position ensures timely verification of insurance benefits and financial clearance which has a direct impact to the organization?s reimbursement from payers for patient accounts that are scheduled and unscheduled. ESSENTIAL FUNCTIONS OF THE ROLE 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 patient?s account prior to scheduled or unscheduled service during the patient?s hosptial 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. KEY SUCCESS FACTORS 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. BENEFITS Our competitive benefits package includes the following - 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 Note: Benefits may vary based upon position type and/or level QUALIFICATIONS - EDUCATION - H.S. Diploma/GED Equivalent - EXPERIENCE - Less than 1 Year of Experience

Responsibilities

The Insurance Verification Specialist verifies insurance eligibility and benefits, ensuring timely financial clearance for patient accounts. This role involves coordinating with physicians and payers to secure necessary authorizations and documentation.