Insurance Verification Spec 1

Baylor Scott & White Health • Dallas, TX

5d

About The Position

The Insurance Verification Specialist 1, under general supervision, provides insurance benefit information to patients, physicians, and hospital staff. The role ensures timely insurance verification and financial clearance, directly affecting the organization's reimbursement from payers for scheduled and unscheduled patient accounts.

Requirements

• High school diploma or GED equivalent.
• Less than one year of experience.
• Ability to consistently meet production, accuracy, completeness, and quality performance standards.
• Ability to understand and follow payer guidelines by plan and service type.
• Good listening, interpersonal, and communication skills, with professional, pleasant, and respectful telephone etiquette.
• Ability to maintain a professional demeanor in stressful and emotional environments, including interactions involving behavioral health and suffering patients and life-or-death situations.
• Empathy and effective communication with patients and families during traumatic events, along with exceptional customer service skills.
• Ability to manage multiple, changing priorities effectively and in an organized manner.
• Excellent data entry, numeric, typing, and computer navigation skills; basic computer skills and Microsoft Office.

Nice To Haves

• One year of healthcare or customer service experience preferred.

Responsibilities

• Perform financial clearance of patient accounts by verifying insurance eligibility and benefits, and ensure notifications and authorizations are completed on time.
• Complete appropriate payer forms related to notification and authorization.
• Coordinate submission of clinical documentation from physicians to payers for authorization needs.
• Calculate accurate patient financial responsibility.
• Communicate promptly with Utilization Review and collaborate with physicians and facility staff to ensure financial clearance before services during a hospital stay.
• Interpret complex payer coverage information, including network participation status, limited plan coverage, and inactive benefits.
• Document systems according to Insurance Verification guidelines to support accurate and timely reimbursement.

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED