Insurance Verification Rep

As an Insurance Verification Representative, you will provide critical pre-service support and meticulous verification of patient insurance benefits, ensuring financial clarity and a smooth patient experience.

Every day you will expertly contact insurance payers, confirm coverage details, identify patient responsibilities, and meticulously document all findings to facilitate accurate billing and address potential financial barriers to care.

To be successful, you will demonstrate outstanding attention to detail, strong communication skills, and a persistent, customer-focused demeanor, contributing significantly to revenue integrity and informed patient access.

• Ensures payers are listed Accurately, pertaining to primary, secondary, and/or tertiary coverage and billing when a patient has multiple third party/governmental payers listed on an account.
• Process patient accounts and deploy established policies to resolve insurance issues with patient accounts with/without supervision i.e. conference calls with employer, payer and physician office staff
• Initiate pre‐cert for in‐house patients when required, obtaining pre‐certification reference number, approved length of stay, and utilization review company contact person and telephone number.
• Obtain authorization for scheduled patients and notify physician’s offices when the authorization is not on file with the patient’s insurance plan.
• Document appropriate authorization numbers in HBOC approval field number 7 to appear on the UB for billing.
• Notify hospital Case Managers on all in‐house patients regarding insurance plan changes/COB order, out of network plans, and Medicare supplemental plans that require pre‐certification.

• High School Graduate or GED
• Two (2) years relevant experience

Baylor St. Luke’s Medical Center is an 1,045 bed facility located in the Texas medical center. A joint venture with Baylor College of Medicine, Baylor St. Luke’s is an internationally recognized leader in research and clinical excellence that has given rise to breakthroughs in cardiovascular care, neuroscience, oncology, transplantation, and more. The hospital is home to the Dan L Duncan Comprehensive Cancer Center, a nationally-accredited and NCI-designated comprehensive cancer center. Our new McNair Campus is designed around the human experience—modeled on evidence-based practices for the safety of patients, visitors, staff, and physicians. The 27.5-acre campus represents the future of healthcare through a transformative alliance focused on leading-edge patient care, research, and education.