Senior Patient Affairs Specialist
This job is no longer accepting applications.
Verifies coverage, benefits and obtains prior authorization or predetermination for upcoming surgeries, procedure and radiology services. Provides great customer service during interaction with patients, providers, Baylor staff, insurance companies and anyone else while performing all job duties. This position is located at St. Luke’s/Bertner.
- Responds to and assists physicians with patient questions.
- Obtains benefits, creates estimates for patient out of pocket, and submits authorizations for services.
- Follows up on submitted authorizations, notates authorization in appropriate area in Epic for all services.
- Contacts patient to collect out of pocket expenses.
- Contacts departments regarding missing clinical information if required by insurance company.
- Contacts PCP offices to obtain referrals.
- Understands high level specialty services authorizations and can pull appropriate clinical documentation for case submission.
- Updates referral statuses and collection efforts in Epic.
- Answers Insurance Verification Helpline and resolves insurance inquiries from patients, physicians, and departments.
- Responds to specific account inquiries by management.
- Creates estimates and collects patient out of pocket prior to services being rendered.
- Provides and explains educational material to patients
- Investigates patient insurance coverage and demographic issues.
- Researches claims denied for no authorization and performs retro authorizations.
- Assists with STAT verification requests in a timely matter.
- Understands high-level multi-specialty services.
- Communicate status updates to MD office representatives and patients.
- Answers phones and provides information to patients or takes detailed messages and routes them to the appropriate party.
- High school diploma or GED.
- Three years of relevant experience.
- Epic experience.
- Authorization submission and follow up experience.
- Medical Doctor office experience.
Baylor College of Medicine requires employees to be fully vaccinated -subject to approved exemptions-against vaccine-preventable diseases including, but not limited to, COVID-19 and influenza.
Baylor College of Medicine is an Equal Opportunity/Affirmative Action/Equal Access Employer.
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