Insurance Verification Specialist

Baxter International Inc.•Houston, TX

6d•$43,200 - $64,800•Hybrid

About The Position

The Insurance Verification Specialist helps reintegrate patient accounts into the reimbursement process by obtaining prior authorization, updating insurance information, or securing payment on claims. The role investigates accounts in the “Error processing” process to identify reimbursement barriers and provide summaries for resolution. It verifies patient demographics and benefits, processes claims, resolves delays, identifies payer trends, and follows reimbursement procedures through review of revenue reports. The specialist contacts patients, families, and caregivers to confirm relevant information and works with sales and internal and external Cardiology Healthcare teams. The role provides customer service and information about payer policies, coverage criteria, plans, and products. It also requires adherence to Baxter and third-party payer policies, with a focus on quality and compliance. The position follows Baxter’s flexible workplace policy, which requires a minimum number of onsite days each week; the number is not specified. The estimated annual base salary is $43,200–$64,800, depending on factors including location, skills, expertise, and experience.

Requirements

High school diploma or equivalent experience.
2–3 years of healthcare-related revenue cycle experience, with a specialized focus on eligibility and benefit verification and claims submission.
Knowledge of Federal, State, and Local regulations, guidelines, and standards, including working knowledge of HIPAA rules and regulations.
Strong written, verbal, and interpersonal communication skills.
Excellent customer service skills, including the ability to deescalate conflict effectively and quickly.
Strong critical-thinking and problem-solving abilities.
Proficiency in Microsoft Office Software.

Nice To Haves

Associate’s degree or higher preferred.
Cardiology-related experience is a plus.
Proven third-party payer experience is strongly preferred.
Experience reviewing medical records to identify and ensure medical necessity.

Responsibilities

Develop strategies to reintegrate patient accounts into the reimbursement process through prior authorization, insurance changes, or claim payment.
Research patient accounts in the “Error processing” process, identify reimbursement barriers, and provide summaries for resolution.
Use investigative tools, including classified and confidential databases, to find patient contact information.
Ensure patient demographics and benefit information are accurate to minimize claim submission errors.
Process claims promptly and resolve issues delaying processing and adjudication.
Identify payer trends and implement payer-specific strategies to address reimbursement challenges.
Review revenue reports, including “claim validation” and “return billing report,” to ensure reimbursement procedures are followed.
Contact patients, families, and caregivers to obtain current demographic, insurance, physician, and device-usage information.
Follow up on and complete errors received and authorizations initiated in a timely manner.
Maintain favorable relationships with the sales team and internal and external Cardiology Healthcare teams.
Provide customer service and discuss payer policies, coverage criteria, and relevant plan and product information with patients and internal and external teams.
Seek additional experience and knowledge across functional areas.
Follow Baxter and third-party payer policies and uphold quality and compliance standards.

Benefits

Medical and dental coverage beginning on day one for eligible roles.
Basic life, accident, short-term disability, long-term disability, and business travel accident insurance.
Employee Stock Purchase Plan (ESPP) with the ability to purchase company stock at a discount.
401(k) Retirement Savings Plan with employee contributions and company matching options.
Flexible Spending Accounts.
Educational assistance programs.
Paid holidays and paid time off ranging from 20 to 35 days based on length of service.
Family and medical leaves of absence.
Paid parental leave.
Commuting benefits.
Employee Discount Program.
Employee Assistance Program (EAP).
Childcare benefits.