Insurance Verification Specialist 1
Company: Baylor Scott & White Health
Posted on: January 16, 2022
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.
ESSENTIAL FUNCTIONS OF THE ROLE
- Performs financial clearance of patient accounts by verifying
insurance eligibility and benefits and ensuring all notifications
and authorizations are completed within the required
- Completes appropriate payor forms related to notification and
- 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 patient?s account prior to scheduled or
unscheduled service during the patient?s hosptial 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
- 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
- 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
- Demonstrates ability to manage multiple, changing priorities in
an effective and organized manner.
- Excellent data entry, numeric, typing and computer navigational
- Basic computer skills and Microsoft Office.
Our competitive benefits package includes the following
- 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 1Note: Benefits may vary based upon
position type and/or level
- EDUCATION - H.S. Diploma/GED Equivalent
- EXPERIENCE - Less than 1 Year of Experience
Keywords: Baylor Scott & White Health, Dallas , Insurance Verification Specialist 1, Other , Dallas, Texas
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