Summary

This position is part of Baylor College of Medicine's insurance verification department. Our goal is to provide excellent customer service during interaction with patients, providers, Baylor staff, insurance companies, and other parties.

The ideal candidate must be able to prioritize the workload to meet productivity standards, as well as support departmental goals by assisting with additional duties or special projects as assigned, contributing to continuous improvement of workflow.

This position is remote, but reporting to our Greenway Plaza location may be required.

Job Duties

• Obtains benefits and verifies insurance authorizations for medical surgeries, procedures, treatments, and services in a timely and efficient manner to prevent delays in patient care.
• Confirms provider’s participation status with patient’s insurance plan/network.
• Interperets patient benefits to include deductibles, copayments, and coinsurance.
• Assists patients in understanding their insurance benefits and coverage limitations.
• Contacts and follows through with patient and PCP to secure payer required referral for planned services.
• Provides financial information to patients obtained during the verification process by financial clearance staff including cost estimates, payment plans, and discounts.
• Answers in-bound calls and addresses e-mails from patients, physicians, and departments in a timely manner.
• Reliably routes patients to the appropriate destination with warm transfers whenever possible.
• Reviews, updates, and maintains accurate demographic and insurance data in the EMR system.
• Maintains accurate and completes documentation of all inquiries.
• Proactively communicates with leadership regarding potential issues and concerns.

Minimum Qualifications

• High school diploma or GED.
• Three years of relevant experience.

Preferred Qualifications

• Minimum of 3 years of experience in medical insurance verification, prior authorization, or related healthcare administrative work.
• Proficiency in using electronic health records (EHR) systems and payer portals.
• Excellent communication and interpersonal skills, with the ability to interact professionally with payors, clinical staff, and internal departments.
• Strong attention to detail, organizational skills, and the ability to manage multiple requests and deadlines in a fast-paced environment.