Spec, Insurance Verification

Baxter • Houston, TX

11d

About The Position

This is where your work makes a difference. At Baxter, we believe every person—regardless of who they are or where they are from—deserves a chance to live a healthy life. It was our founding belief in 1931 and continues to be our guiding principle. We are redefining healthcare delivery to make a greater impact today, tomorrow, and beyond. Our Baxter colleagues are united by our Mission to Save and Sustain Lives. Together, our community is driven by a culture of courage, trust, and collaboration. Every individual is empowered to take ownership and make a meaningful impact. We strive for efficient and effective operations, and we hold each other accountable for delivering exceptional results. Here, you will find more than just a job—you will find purpose and pride. Your role: The Insurance Verification Specialist (Non-Discovery) provides direct support to the Revenue Cycle Management Department, which includes Reimbursement Services, Cash Application, Patient Account Specialist, Billing and Collections. This position is required to collaborate cross-functionally with other Cardiology healthcare teams to coordinate and align in our mission statement of Saving and Sustaining Lives. The Insurance Verification Specialist position is responsible for verifying patients’ insurance coverage, obtaining eligibility and benefits information, securing authorizations when applicable and preparing accurate financial estimates/quotes for medical services. This role ensures patients understand their coverage, estimated out-of-pocket costs, and payment responsibilities prior to treatment supporting both patient satisfaction and revenue cycle efficiency. Additionally, this position will work with the management team to identify process and procedure gaps, to ensure maximum reimbursement potential.

Requirements

• High school diploma or equivalent required, Associate’s or Bachelor’s degree preferred.
• 2+ years of healthcare related experience in the revenue cycle process with a specialized focus around eligibility and benefit verification, claims submission.
• Knowledge of Federal, State, and Local regulations, guidelines, and standards, payer rules, medical coding basics (ICD-10, CPT) including a working knowledge of HIPAA rules and regulations.
• Experience with medical record reviews to identify and ensure medical necessity.
• Ability to work independently and in a team environment.
• Possess the ability to manage time and prioritize critical priorities.
• Proficiency in Microsoft Office Software.

Nice To Haves

• Cardiology related experience a plus.

Responsibilities

• Verify insurance eligibility and benefits for patients using payer portals, phone calls and electronic systems.
• Review and interpret insurance plans, coverage limitations, exclusions and coordination of benefits.
• Calculate patient financial responsibility including deductibles, co-pays, co-insurance and non- covered services.
• Obtain prior authorizations, referrals and pre-certifications when required by insurance carriers.
• Document all verification details, benefit information, and communications in the billing system.
• Identify payer trends and establish payer-specific strategies to overcome reimbursement challenges.
• Communicate effectively with patients regarding their insurance benefits, financial estimates and payment options.
• Contact patients/families/caregivers/Clients and Account Executives as needed to obtain current demographics, insurance, physician, and device usage, to ensure appropriate insurance reimbursement.

Benefits

• Baxter offers comprehensive compensation and benefits packages for eligible roles.
• Our health and well-being benefits include medical and dental coverage that start on day one, as well as insurance coverage for basic life, accident, short-term and long-term disability, and business travel accident insurance.
• Financial and retirement benefits include the Employee Stock Purchase Plan (ESPP), with the ability to purchase company stock at a discount, and the 401(k) Retirement Savings Plan (RSP), with options for employee contributions and company matching.
• We also offer Flexible Spending Accounts, educational assistance programs, and time-off benefits such as paid holidays, paid time off ranging from 20 to 35 days based on length of service, family and medical leaves of absence, and paid parental leave.
• Additional benefits include commuting benefits, the Employee Discount Program, the Employee Assistance Program (EAP), and childcare benefits.

What This Job Offers

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