Access Services Insurance Verification Specialist 2

Baylor Scott & White Health; Duncanville (TX); On-site; USD 42,000 - 56,000; Full time

Benefits offered by this job

Health benefits

401(k) match

Tuition reimbursement

PTO Day 1

Job summary

Baylor Scott & White Health seeks an Insurance Verification Specialist 2 to provide insurance benefit information to patients, physicians, and hospital staff, ensuring timely verification and financial clearance to support payer reimbursements.

The role involves coordinating documentation with physicians, calculating patient responsibility, and communicating with Utilization Review and care teams to maintain smooth operations during hospital stays.

Qualifications

• 2 years of healthcare or customer service experience or education equivalency.
• Ability to consistently meet performance standards of production, accuracy, completeness and quality.
• Maintain a professional demeanor in stressful environments and communicate effectively with patients and staff.

Responsibilities

• Verify insurance eligibility and benefits to complete financial clearance.
• Complete payor forms related to notification and authorization.
• Coordinate submission of clinical documentation from physicians to payers.
• Calculate patient financial responsibility.
• Communicate with Utilization Review and hospital staff to ensure financial clearance before services.
• Interpret payer coverage details including network participation and plan limitations.
• Document workflows according to Insurance Verification guidelines to ensure accurate reimbursement.
• Manage workflow in the designated area to maximize department results.

Skills

Healthcare experience

Customer service

Communication skills

Multitasking

Empathy

Education

HS Diploma/GED

Tools

MS Office

Job description

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.

Benefits

Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include:

• 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 2 provides insurance benefit information to patients, physicians, and hospital staff. This role ensures timely insurance verification and financial clearance. It directly impacts the organization's reimbursement from payers for both scheduled and unscheduled patient accounts. This position also helps with complex issues and manages workflow.

Essential Functions Of The Role

• Perform financial clearance of patient accounts by verifying insurance eligibility and benefits. Ensure all notifications and authorizations are completed on time.
• 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 promptly with Utilization Review. Partners 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.
• Assists co-workers, facility customers with complex questions and issues.Documents systems according to the Insurance Verification guidelines to assure accurate and timely reimbursement.
• Manages workflow of specific area to ensure maximum results for department as requested.

Key Success Factors

• 2 years of healthcare or customer service experience or education equivalency required.
• Must have the ability to consistently meet performance standards of production, accuracy, completeness and quality.
• Ability to know and adhere to payer guidelines by plan and service type.
• Requires good listening and communication skills, and professional telephone etiquette.
• Maintain a professional demeanor in stressful and emotional environments. Handle behavioral health and suffering patients, as well as life or death situations.
• Must exhibit high empathy and communicate well with patients and families during trauma. 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 Microsoft Office.

Belonging Statement

We believe that all people should feel welcomed, valued and supported.

Qualifications

• EDUCATION - H.S. Diploma/GED Equivalent
• EXPERIENCE - 2 Years of Experience