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Baxter International

Global provider of medical care products

Insurance Verification Specialist

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours
Full-timeHouston, TX, USA$43.2k - $64.8k /yr

About the Job

Requirements

  • A high school diploma or equivalent experience is required.
  • Two to three years of healthcare-related experience in the revenue cycle process, specializing in 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.
  • Experience with medical record reviews to identify and ensure medical necessity.
  • Written, verbal, and interpersonal communication skills.
  • Customer service skills and the ability to deescalate conflict effectively and quickly.
  • Critical thinking and problem-solving abilities.
  • Proficiency in Microsoft Office software.

Responsibilities

  • Develop a strategy to reintegrate patient accounts into the reimbursement process through prior authorization, insurance changes, or securing payment on claims.
  • Research patient accounts in the error-processing process to identify reimbursement gaps and provide a summary for resolution.
  • Use investigative tools, including classified and confidential databases, to find patient contact information.
  • Ensure patient demographics and benefit information on file are accurate to minimize claim submission errors.
  • Process claims promptly and identify and resolve issues causing delayed processing and adjudication.
  • Identify payer trends and implement payer-specific strategies to overcome reimbursement challenges.
  • Review revenue reports, including claim validation and return billing reports, to ensure reimbursement procedures are followed.
  • Contact patients, families, and caregivers as needed to obtain current demographics, insurance, physician, and device-usage information for appropriate insurance reimbursement.
  • Follow up on and complete errors received and authorizations initiated in a timely manner.
  • Maintain relationships with the sales team and internal and external Cardiology Healthcare teams.
  • Discuss payer policies, coverage criteria, and relevant plan and product information with patients, the sales team, and internal and external Cardiology Healthcare teams to provide customer service.
  • Seek additional experience and knowledge across functional areas to build expertise.
  • Adhere to Baxter and third-party payer policies and ensure quality and compliance.

Desired Qualifications

  • An associate’s degree or higher is preferred.
  • Cardiology-related experience is a plus.
  • Third-party payer experience is strongly preferred.

About the Company

Baxter International

Global provider of medical care products

Baxter International develops and manufactures medical products and equipment for hospitals and blood banks. Its products include sterile IV solutions and blood storage containers; innovations like the Transfuso-Vac extended blood shelf life, and a plastic blood bag helped shape modern blood banking. The company differs from competitors through a long track record of sterile manufacturing, blood-storage innovations, and strategic mergers that broaden its product portfolio. Its goal is to provide reliable, safe medical products that support patient care and hospital operations worldwide.

Company size
10,001+
Company stage
IPO
Headquarters
Deerfield, IL
Founded
1931

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