Insurance Verification Specialist I - Kelsey Seybold - Pearland TX
About The Position
The Insurance Verification Specialist I works in a hybrid arrangement in Pearland, Texas, for Kelsey-Seybold Clinic, part of the Optum family of businesses. The role verifies insurance eligibility and benefits, determines insurance filing order, and prepares patient pre-treatment cost-share estimates using the service schedule, contracted plan reimbursement allowances, benefits, and out-of-pocket thresholds. It also maintains accurate patient demographic and insurance information in the Practice Management System. The specialist communicates with patients by phone or electronically to explain coverage, benefits, cost estimates, and financial liability; advises patients about non-covered services; accepts payments; and establishes payment plans in accordance with department policies. The role calls for exceptional customer service and contributes to a positive patient experience. The position offers development opportunities and performance recognition. The hourly pay range is $16–$29, based on full-time employment and factors including local labor markets, education, work experience, and certifications.
Requirements
- High school diploma or GED from an accredited program.
- At least 1 year of experience in a similar field involving insurance verification, patient accounts, or medical office functions; or at least 6 months of experience with completion of a Medical Billing & Coding course; or at least 6 months of registration, scheduling, or front desk experience at Kelsey-Seybold Clinic.
- Demonstrated MS Office, computer, and internet skills, including fast and accurate computer and typing skills.
- Demonstrated basic PC literacy.
- Demonstrated alpha/numeric form-entry skills.
- Demonstrated good verbal and written customer service skills.
- Demonstrated basic knowledge of health insurance.
- Ability to add and subtract 4-digit numbers and apply percentages and discounts.
- For the hybrid arrangement, must have a personal laptop or desktop, monitor, and keyboard at home.
Nice To Haves
- At least 2 years of experience in a medical office environment handling insurance verification, with knowledge of a wide range of products.
- Kelsey-Seybold experience.
- Demonstrated knowledge of insurance concepts and theory.
- Epic experience.
- Demonstrated high PC proficiency.
- Demonstrated excellent communication skills.
Responsibilities
- Verify insurance eligibility and benefits.
- Determine insurance filing order.
- Prepare patient pre-treatment cost-share estimates based on service schedules, contracted plan reimbursement allowances, benefits, and out-of-pocket thresholds.
- Accurately enter or update patient demographics, insurance coverage, effective and termination dates, and filing order in the Practice Management System.
- Communicate with patients by phone or electronically to explain coverage, benefits, pre-treatment cost estimates, and patient financial liability.
- Advise patients about non-covered services, take payments, and set up payment plans in accordance with department policies.
- Provide exceptional customer service and a positive patient experience.
Benefits
- Comprehensive benefits package, subject to eligibility requirements.
- Incentive and recognition programs.
- Equity stock purchase plan.
- 401(k) contribution.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
