Insurance Verification Specialist (Authorization Processing)

vmysmartpros; India; On-site; INR 350,000 - 550,000; Full time

Benefits offered by this job

Health and welfare benefits

Tuition Reimbursement

PTO accrual beginning Day 1

401(k) savings plan with match

Job summary

reputed company is seeking an Insurance Verification Specialist 1 to provide insurance benefit information to patients, physicians, and hospital staff. You will verify eligibility and help secure financial clearance for scheduled and unscheduled accounts.

Under general supervision, you will coordinate payor forms, obtain authorizations, and communicate with Utilization Review, physicians and staff to ensure timely reimbursement and accurate patient financial responsibility.

Qualifications

• HS Diploma or GED equivalent required.
• 3 years of Authorization Processing experience preferred.
• Experience with health care intake and insurance workflows is a plus.

Responsibilities

• Verify insurance eligibility and benefits for patient accounts.
• Ensure timely financial clearance and payer notifications.
• Coordinate submission of clinical documentation to payers for authorization needs.
• Calculate patient financial responsibility and communicate clearly with stakeholders.
• Collaborate with Utilization Review, physicians and facility staff.

Skills

Customer service

Data entry

Communication skills

Attention to detail

Computer literacy

Education

HS Diploma/GED

Tools

MS Office

Job description

About Us

Here at reputed company we promote the well-being of reputed company 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 reputed company.
• We are in it together by supporting one another and those we serve.
• We reputed company an impact by taking initiative and delivering exceptional experience.

Benefits

• 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.

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.

Essential Functions Of The Role

reputed company financial clearance of patient accounts by verifying insurance eligibility and benefits. Ensure reputed company notifications and authorizations are completed on time.

Completes appropriate payor forms reputed company to notification and authorization.

Coordinates the submission of clinical documentation from physicians to payers for authorization needs.

Calculates accurate patient financial responsibility.

Communicates promptly with Utilization Review. Collaborates effectively with the physician and facility staff. Ensures financial clearance of the patient's account before any service during the hospital stay.

Interprets reputed company 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.

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.
• Maintain a professional demeanor in stressful and emotional environments. Handle behavioral health and suffering patients, including life or death situations.
• Must exhibit high reputed company and communicate well with patients and families during traumatic events. Demonstrate 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 reputed company Office.

Belonging Statement

We reputed company that reputed company people should feel welcomed, valued and supported.

Qualifications

EDUCATION - H.S. Diploma/GED Equivalent

EXPERIENCE - 3 years of Authorization Processing Experience