Access Services Insurance Verification Specialist 2

International Association of Insurance Professionals (IAIP); Duncanville, Northern (TX, KY); Hybrid; USD 42,000 - 54,000; Full time

Benefits offered by this job

Health benefits

401k match up to 5%

Tuition Reimbursement

PTO Day 1

Job summary

Baylor Scott & White Health in Duncanville, TX seeks an Insurance Verification Specialist 2 to provide insurance benefit information to patients, physicians and hospital staff, ensuring timely verification and financial clearance for scheduled and unscheduled accounts.

You will interpret payer guidelines, coordinate documentation, and work with Utilization Review to secure authorization before services, maintaining accuracy and high-quality customer service in a fast-paced hospital setting.

Qualifications

• 2 years healthcare or customer service experience or education equivalency required.
• Must meet production, accuracy, and quality standards.
• Must adhere to payer guidelines by plan and service type.
• Good listening/communication skills and professional phone etiquette.

Responsibilities

• Perform financial clearance by verifying insurance eligibility and benefits; ensure timely notifications and authorizations.
• Complete payor forms related to notification and authorization.
• Coordinate submission of clinical documentation for payer authorization needs.
• Calculate accurate patient financial responsibility.
• Communicate with Utilization Review; coordinate with physicians and staff to ensure clearance before services.
• Interpret complex payer coverage info including network participation and limited plan coverage.
• Assist coworkers and facility customers with complex questions and issues.
• Document systems per Insurance Verification guidelines to ensure timely reimbursement.

Skills

Healthcare experience

Customer service experience

Education

HS Diploma/GED

Tools

Microsoft 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

• 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