Medical Records and Authorization Specialist

Baxter • Houston, TX

7h • Onsite

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. You Role at Baxter Perform Medical Records and Authorization Specialist duties including documentation collection and review, prior authorization and reauthorization submissions, The Medical Records and Authorization Specialist communicates directly with client medical records depts, patients, healthcare teams, sales teams, and insurance companies as well as collaborating cross-functionally with other Cardiology Health teams to coordinate in our mission of Saving and Sustaining Lives.

Requirements

• High school diploma or equivalent required, Associates degree or higher preferred
• 3+ years of industry experience in health insurance
• Knowledge of Federal, State, and Local regulations, guidelines, and standards, including a working knowledge of HIPAA rules and regulations
• Third party payer experience strongly preferred.
• Experience in reviewing medical records and obtaining third-party payer reimbursement.
• Exceptional written, verbal, and interpersonal communications
• Strong critical thinking and problem-solving skills
• Detail orientated and ability to multi-task
• Ability to work independently as well as in a team environment
• Possess the ability to manage time and prioritize critical priorities
• Proficiency in Microsoft Office Software

Responsibilities

• Ensure coverage and payer requirements.
• Gather clinical documentation to support medical necessity for Cardiology devices.
• Process paper and electronic correspondence, including logging and distribution of payer and patient inquiries.
• Establish and maintain positive partnerships with sales team and healthcare teams.
• Review and assess clinical documentation to ensure all applicable coverage criteria requirements are met.
• Prepare and submit prior authorization initial and renewal requests to all insurance companies including.
• Process authorization decisions from payers timely to streamline and drive revenue.
• Identify payer trends and establish payer-specific strategies to overcome reimbursement challenges.
• Provide superior customer experience by leveraging the ability to discuss payer policies, coverage criteria, or any pertinent product information with patients and healthcare teams.
• Understand and adhere to all policies for Baxter and 3rd party payers to ensure the highest standards of quality and compliance.
• Consistently contribute to team goals and understand how they support greater organizational goals.
• Actively seek additional experience and knowledge across all functional areas to gain expertise.
• Provide workload coverage as needed.
• Perform other duties and projects as assigned.

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.
• Join us and enjoy the competitive compensation and benefits we offer to our employees.
• For additional information regarding Baxter US Benefits, please speak with your recruiter or visit our Benefits site: Benefits | Baxter

What This Job Offers

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