Remote - Insurance Verification Specialist

Baylor Scott & White Health; Dallas (TX); On-site; USD 35,000 - 45,000; Full time

Benefits offered by this job

Health and welfare benefits

401(k) savings plan

Tuition reimbursement

PTO accrual from Day 1

Job summary

A healthcare organization in Dallas is seeking an Insurance Verification Specialist 1. In this role, you will provide patients and staff with insurance benefit information while ensuring timely verification and financial clearance for scheduled hospital services. Ideal candidates will possess strong customer service skills, data entry abilities, and be able to communicate effectively under stress. This position offers benefits including health coverage and a 401(k) savings plan.

Qualifications

• Less than 1 Year of Experience in healthcare or customer service preferred.
• Ability to maintain professionalism in stressful situations.
• Good listening and interpersonal skills required.

Responsibilities

• Verify insurance eligibility and benefits.
• Ensure timely financial clearance of patient accounts.
• Calculate patient financial responsibility.

Skills

Customer service skills

Data entry skills

Communication skills

Education

H.S. Diploma/GED Equivalent

Tools

Microsoft Office

Job description

Overview

The Insurance Verification Specialist 1, under general supervision, provides patients, physicians and internal hospital personnel with insurance benefit information. This position ensures timely verification of insurance benefits and financial clearance which has a direct impact to the organization's reimbursement from payers for patient accounts that are scheduled and unscheduled.

Responsibilities

• Performs financial clearance of patient accounts by verifying insurance eligibility and benefits and ensuring 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 timely with Utilization Review, and collaborates effectively with physician and facility staff to ensure financial clearance of the patients account prior to scheduled or unscheduled service during the patient’s hospital stay.
• Interprets complex payer coverage information including, but not limited to, network participation status with provider, limited plan coverage and inactive benefits.
• Documents systems according to the Insurance Verification guidelines to assure accurate and timely reimbursement.

Key Success Factors

• 1 Year Of Healthcare Or Customer Service Experience Preferred.
• 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.
• Ability to maintain a professional demeanor in a highly stressful and emotional environment, behavioral health and/or suffering patients in addition to life or death situations.
• Must be able to exhibit a high level of empathy with the ability to effectively communicate with patients and family members during traumatic events, while demonstrating 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.

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

Qualifications

• EDUCATION - H.S. Diploma/GED Equivalent
• EXPERIENCE - Less than 1 Year of Experience