ABOUT US

Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well.

Our Core Values are:

• We serve faithfully by doing what’s right with a joyful heart.
• We never settle by constantly striving for better.
• We are in it together by supporting one another and those we serve.
• We make an impact by taking initiative and delivering exceptional experience.

JOB SUMMARY

The Insurance Verification Specialist 1, under general supervision, provides insurance benefit information to patients, physicians, and hospital staff. This position ensures timely insurance verification and financial clearance. This directly impacts the organization’s reimbursement from payers for both scheduled and unscheduled patient accounts.

QUALIFICATIONS

• EDUCATION - H.S. Diploma/GED Equivalent
• EXPERIENCE - Less than 1 Year of Experience

• Perform financial clearance of patient accounts by verifying insurance eligibility and benefits. Ensure 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. Collaborates effectively with physician and facility staff. Ensures financial clearance of the patient’s account before any service during the hospital stay.
• Interprets complex payer coverage information, including network participation status, limited plan coverage, and inactive benefits.
• Documents systems according to the Insurance Verification guidelines to assure accurate and timely reimbursement.