Access Services Insurance Verification Specialist 2

NACBA; Duncanville, Northern (TX, KY); Hybrid; USD 42,000 - 62,000; Full time

Benefits offered by this job

Health benefits

401(k) with match

Tuition Reimbursement

PTO from Day 1

Job summary

Baylor Scott & White Health is seeking an Insurance Verification Specialist 2 to provide insurance benefit information to patients, physicians, and hospital staff. The role ensures timely verification and financial clearance, directly affecting reimbursement from payers for both scheduled and unscheduled accounts.

Responsibilities include obtaining authorizations, coordinating payor forms, and supporting staff with complex questions while maintaining accurate documentation and adherence to

Qualifications

• 2 years of healthcare or customer service experience
• Ability to consistently meet production, accuracy, completeness and quality
• Excellent listening and communication skills with professional telephone etiquette
• Proficiency in data entry and basic computer skills

Responsibilities

• Verify insurance eligibility and benefits to complete financial clearance
• Submit payor notification and authorization forms
• Coordinate submission of clinical documentation for payer authorization
• Calculate and document patient financial responsibility
• Communicate with Utilization Review and care teams for timely clearance
• Interpret payer coverage details and network status for service decisions
• Document processes per Insurance Verification guidelines
• Manage workflow to maximize department results

Skills

Healthcare experience

Customer service

Attention to detail

Data entry

Education

HS Diploma/GED Equivalent

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