Insurance Verification Specialist

Qualifications

Here’s What You Need:

Education

H.S. Diploma or Equivalent required.

Experience

1 year experience in business office in healthcare environment/patient access in hospital setting/call center in healthcare environment/ Revenue Cycle experience in healthcare required.

Working knowledge of Medical Terminology preferred.

Insurance verification knowledge preferred.

Customer service experience preferred.

Licenses and Certifications

CHAA – Certified Healthcare Access Associate Upon Hire preferred.

Skills

Ability to promptly assess requests by using electronic and paper resource materials and correctly respond to patient inquiries. Excellent data entry, numeric, typing and computer navigational skills, with attention to details. Proficient computer skills, medical terminology, Epic, Microsoft Office and assorted software programs. Requires exceptional listening, interpersonal and communication skills, and professional, pleasant and respectful telephone etiquette. Demonstrates ability to manage multiple, changing priorities in an effective and organized manner and appropriately escalating concerns to leadership.

What You Will Do:

·        Demonstrates comprehensive knowledge and effective execution of verification and precertification procedures for services requiring prior authorization. Performs responsibilities with timeliness and a high level of accuracy. Ensures insurance coverage is correctly entered and that all supporting documentation is complete, precise, and compliant with established standards.

·        Collaborates proactively with Pre-Access, Utilization Review, Financial Counseling, and Physician Offices to verify patient accounts prior to scheduled or unscheduled services during hospitalization. Accurately documents all relevant information in accordance with Insurance Verification protocols to support timely and precise reimbursement.

·        Utilizes tools such as Trace, OneSource, Web Portals, etc. to complete verifications, precertifications, and notifications as required in order to ensure the system maximizes revenue for the account. Logs into Avaya System and phone queue.

·        Serves as the primary point of contact for incoming inquiries from healthcare providers, patients, and insurance carriers regarding coverage-related matters. Delivers accurate and courteous responses to ensure clear communication and resolution of insurance-related questions.

·        Functions as a liaison among patients, healthcare providers, and insurance carriers to facilitate access to necessary medical services while ensuring appropriate reimbursement for the hospital. Coordinates communication and processes to support both patient care and financial integrity.

·        Maintains current knowledge of applicable regulations, departmental policies, and system-wide procedures, ensuring full compliance in daily operations. Demonstrates the ability to interpret and adhere to payer-specific guidelines based on plan type and service category to support accurate processing and reimbursement.

·        Actively participates in staff meetings, contributes to process improvement initiatives, supports special projects, and performs additional duties as assigned to enhance departmental efficiency and service quality.

Additional Perks of Being a Texas Health Employee:

Benefits include 401(k) with match, paid time off, competitive health insurance choices, healthcare and dependent care spending account options, wellness programs to keep you and your family healthy, tuition reimbursement, a student loan repayment program and more.

 At Texas Health, our people make this a great place to work every day. Our inclusive, supportive, people-first, excellence-driven culture make THR a great place to work.

Texas Health Arlington Memorial Highlights:

Texas Health Arlington Memorial Hospital has a rich history in North Texas serving the local communities of Arlington, Kennedale, Pantego, Mansfield and Grand Prairie. We’re a 369-bed, acute-care, full-service hospital serving our community since 1958. Our location in central Arlington provides convenient care to people in the DFW Metroplex and surrounding areas.

We specialize in comprehensive medical/surgical care, cancer care, women’s services, behavioral health, neurosciences, and emergency medicine. Plus, we’re a Level III neonatal intensive care unit, Level III Maternal Newborn care unit and a Level III Trauma Center. We’re accredited by the American College of Surgeons as a Comprehensive Community Cancer Center and by the National Accreditation Program for Breast Centers.

Texas Health Arlington Memorial is a Joint Commission-certified Primary Stroke Center, a Chest Pain Center, and a Heart Failure Center. We’ve been recognized by the American Heart Association with a Gold Plus award for the exceptional care we provide to our stroke, heart failure and chest pain patients. We’re also a designated Magnet hospital! Our community members recently recognized us as the best emergency department in Arlington. Plus, we’re recognized by Blue Cross/Blue Shield as a Blue Distinction Center for care of our patients receiving Hip and Knee Replacement and Spine Surgery procedures. We’re a top choice in North Texas for cancer and emergency services, women’s health and much more.

As part of the Texas Health family and its 28,000+ employees, we’re one of the largest employers in the Dallas Fort Worth area. Our career growth and professional development opportunities are top-notch, and our benefits are equally outstanding. Come be a part of our exceptional team as we improve the health of the people in our communities every day. You belong here!

Explore our Texas Health careers site for info like Benefits, Job Listings by Category, recent Awards we’ve won and more.

Do you still have questions or concerns? Feel free to email your questions to recruitment@texashealth.org.