Insurance Verification Specialist 2

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 Job Summary The Insurance Verification Specialist 2 provides insurance benefit information to patients, physicians, and hospital staff. This position ensures timely insurance verification and financial clearance. It directly impacts the organization's reimbursement from payers for scheduled and unscheduled patient accounts. This position also helps with complex issues and manages workflow. Essential Functions of the Role Perform financial clearance of patient accounts by verifying insurance eligibility and benefits. Ensure all notifications and authorizations are completed within the required timeframe. Complete appropriate payer forms related to notification and authorization. Coordinate the submission of clinical documentation from physicians to payers for authorization needs. Calculate accurate patient financial responsibility. Communicate promptly with Utilization Review. Collaborate with the physician and staff to ensure financial clearance before the patient’s service. Interpret complex payer coverage information, including network participation status, limited plan coverage, and inactive benefits. Assist co-workers and facility customers with complex questions and issues. Document systems according to the Insurance Verification guidelines to assure accurate and timely reimbursement. Manage workflow of specific area to ensure maximum results for department as requested. Key Success Factors 2 years of healthcare or customer service experience or education equivalency required. Consistently meet performance standards of production, accuracy, completeness, and quality. Understand and adhere to payer guidelines by plan and service type. Possess good listening, interpersonal and communication skills, and professional, pleasant, and respectful telephone etiquette. Maintain a professional demeanor in stressful, emotional environments with behavioral health or suffering patients, and life or death situations. Demonstrate high empathy and communicate well with patients and families during trauma. Demonstrate exceptional customer service skills. Manage multiple, changing priorities effectively and organized. Excellent data entry, numeric, typing, and computer navigational skills. Basic computer skills and Microsoft Office. Qualifications Educational requirement: H.S. Diploma/GED Equivalent. Experience: 2 years of experience. #J-18808-Ljbffr Baylor Scott & White Health