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Phoenix, Arizona
Posted: 16-Jan-25
Location: Rockwall, Texas
Categories:
Internal Number: 24021002
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 competitive benefits package empowers you to live well and provides:
- Eligibility on day 1 for all benefits
- Dollar-for-dollar 401(k) match, up to 5%
- Debt-free tuition assistance, offering access to many no-cost and low-cost degrees, certificates and more
- Immediate access to time off benefits
At Baylor Scott & White Health, your well-being is our top priority.
Note: Benefits may vary based on 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, and that our workforce should be reflective of the communities we serve.
QUALIFICATIONS
- EDUCATION - H.S. Diploma/GED Equivalent
- EXPERIENCE - 2 Years of Experience