Insurance Verification Specialist - Patient Access

Baxter; Mountain Home (AR); On-site; USD 34,000 - 42,000; Full time

Job summary

Baxter Health in Mountain Home, AR seeks an Insurance Verification Specialist to supervise daily verification of outpatient insurance and eligibility. The role involves contacting provider offices for prior authorizations and coordinating with departments to secure accurate coverage and reimbursements.

Requirements include a high school diploma or equivalent and 12–18 months in healthcare or clerical roles.

Qualifications

• 12 to 18 months related experience in healthcare/clerical/customer service.
• Working knowledge of medical terminology and coding basics (ICD-10, CPT, HCPCS).
• Adaptability to multiple systems and knowledge of employment laws.
• Proficiency with Microsoft Office Suite, databases, and general office equipment.
• Excellent time management and follow-up skills to meet deadlines.
• Strong communication and interpersonal abilities; maintain confidentiality.

Responsibilities

• Oversee daily insurance and eligibility verification for outpatient procedures.
• Contact providers regarding prior authorizations to ensure reimbursement.
• Notify appropriate parties when coverage changes and coordinate authorizations.
• Communicate inter-departmentally and with insurance companies as needed.
• Identify outpatient tests that may require retro-authorization for reimbursement.

Skills

Time management

Interpersonal skills

Communication skills

Attention to detail

Education

High School Diploma or equivalent

Associate Degree in Business Administration or related field (preferred)

Job description

Baxter Health

Mountain Home , AR

Full time , Days , 7AM-3:30 PM (M-F)

SUMMARY

Under the direction of the Patient Access/Central Scheduling Manager, the Insurance Verification Specialist is responsible and accountable for the daily oversight of all Insurance and Eligibility verification for Outpatient procedures as scheduled and/or add on procedures throughout the various hospital departments. Responsible for contacting provider(s) offices regarding the necessity of prior authorizations to ensure appropriate reimbursement. Responsible for contacting the appropriate provider(s) as necessary when Insurance and Eligibility changes in coverage are identified. Utilizes a variety of communication methods to effectively communicate inter-departmentally, with provider(s) offices as well as with Insurance companies. Responsible for the identification of any Outpatient tests/procedures completed that may require retro-authorization in order to obtain reimbursement. Works with multiple hospital departments in the creation of financial accounts as necessary prior to the treatment of the patient. Works continually with schedulers to ensure all authorizations required are in place prior to the scheduling of the test/procedure. Functions as subject matter expert to both internal and external customers.

Education: High School Diploma or equivalent.

Experience: 12 to 18 months related experience and/or training in the healthcare and/or office/clerical and customer service fields.

Other: Preferred applicant will have a working knowledge of medical terminology, ICD 10, CPT and HCPCS coding basics. Adaptability to multiple systems is essential in-depth knowledge of federal and state employment laws. Working knowledge of Microsoft Office Suite, databases and general office equipment. Must be extremely detail oriented, organized and conscientious to ensure high quality work. Excellent time-management and follow-up skills to ensure work deadlines are met. Outstanding communication, presentation and interpersonal skills. Must be a positively contributing team player and possess willingness to be cross-trained in other functional areas. Ability to maintain a high degree of confidentiality with regard to employment data, HIPAA, and departmental operations.

Preferred

Associate Degree in Business Administration or related field preferred.

Safety Sensitive Designation

No

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job with or without an accommodation. While performing the duties of this job, the employee is required to perform the following: Must have the ability to communicate effectively, orally and in writing, to solve problems and make decisions. Spend 8 hours or more in front of computer, monitor or similar screen utilizing keyboard and/or mouse, daily. Ability to stand and walk, bend, stoop and twist, and occasionally lift 20 lbs. Acuity to the five senses is required. Must be able to handle critical and highly stressful situations with efficiency and composure.