Insurance Verification Specialist 2

Baylor Scott & White Health; Dallas (TX); On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Immediate eligibility for health and w

401(k) savings plan with dollar-for-dx

Tuition Reimbursement

PTO accrual beginning Day 1

Job summary

Baylor Scott & White Health in Dallas seeks an Insurance Verification Specialist 2 to provide insurance benefit information to patients, physicians, and hospital staff. You will verify eligibility, determine financial clearance, and help ensure reimbursement for scheduled and unscheduled services.

You will collaborate with Utilization Review and physicians, manage payer forms and documentation, and handle complex questions with empathy while maintaining accuracy and timely communication in a

Qualifications

• 2 years of healthcare or customer service experience or education equivalency.
• Ability to meet production, accuracy, and quality standards.
• Understanding payer guidelines by plan and service type.
• Strong listening, interpersonal and communication skills; professional telephone etiquette.
• Empathetic approach to patients and families in challenging situations.

Responsibilities

• Perform financial clearance by verifying insurance eligibility and benefits.
• Complete payor forms related to notification and authorization.
• Coordinate submission of documentation from physicians to payers for authorization needs.
• Calculate accurate patient financial responsibility.
• Communicate with Utilization Review; ensure financial clearance before service.
• Interpret payer coverage information, including network participation and limited plans.
• Assist colleagues and facility customers with complex questions.
• Document systems per Insurance Verification guidelines for timely reimbursement.
• Manage workflow in area to maximize department results.

Skills

Customer service

Communication

Attention to detail

Medical terminology

Education

HS Diploma/GED

Tools

Microsoft Office

EHR systems

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 position ensures timely insurance verification and financial clearance. It directly impacts the organization's reimbursement from payers for 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 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 promptly with Utilization Review. Collaborates with the physician and staff to ensure financial clearance before the patient's service.
• Interprets complex payer coverage information, including network participation status, limited plan coverage, and inactive benefits.
• Assists co-workers and 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 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, emotional environments with behavioral health or suffering patients, and 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

As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.