Summary

This position is part of Baylor College of Medicines insurance verification department. Our goal is to provide great customer service during interaction with patients, providers, Baylor staff, insurance companies and anyone else while performing all job duties. The ideal candidate must be able to prioritize workload in order to meet productivity standards, as well as support departmental goals by assisting with additional duties or special projects as assigned, contributing to the continuous improvement of workflow.

Patient Affairs Specialist works from a designated work queue with assigned accounts to work throughout their shift.  These accounts consist of procedures and/or surgeries performed in either an office or hospital setting. The representative tasks will include but not limited to, verifying benefits for services and financially clearing patients.

This position is located at our Greenway Plaza location.

Job Duties

• Obtain benefits and verify insurance authorizations for medical 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.
• Interprets patient benefits to include deductibles, copayments, and coinsurance.
• Assists patients in understanding their insurance benefits and coverage limitations.
• 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 complete documentation of all inquiries.
• Proactively communicates with leadership regarding identified potential issues and concerns.
• Performs other job-related duties as assigned.

Minimum Qualifications

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

Preferred Qualifications

• EPIC experience.
• Medical insurance verification, prior authorization, or related healthcare administrative work.