Full employer posting
Beacon Health System is hiring a full-time day shift Patient Access Insurance Specialist position for our Verification of Benefits department at Beacon Health System in Granger, IN . Be a Beacon. Make a Difference.
At Beacon Health System, you’re not just part of a team, you’re part of something bigger. Every patient interaction is a chance to lead with compassion, build trust, and create lasting impact. Here, your expertise supports healing, and your heart connects us to the communities we serve.
We offer a wide variety of benefits for our employees, including: Medical, Dental, & Vision Insurance through Cigna Life Insurance 403(b) Matching Retirement Fund Competitive Paid Time Off (PTO) Shift Differentials Employee Assistance Program (EAP) Tuition and Certification Reimbursement Clinical Ladder Program Local and National Discounts Beacon Academy Educational Courses Gym Membership Discount About Beacon Health System Headquartered in South Bend, Indiana, as a not-for-profit, community-governed health system, Beacon Health System provides care to more than 4,000 patients each day in northern Indiana and southern Michigan.
What You’ll Do As a Patient Access Insurance Specialist, you'll report to the Patient Access Director or Insurance Specialist Supervisor and play a key role in ensuring patients receive timely access to covered healthcare services. You will verify insurance coverage, obtain required authorizations, pre-certifications, and approvals for procedures, diagnostic testing, admissions, and hospitalizations before services are rendered.
In this role, you will collaborate closely with medical staff, clinical teams, referring clinics, Beacon Outpatient Scheduling, Surgery Scheduling, Social Services, and Utilization Review departments to coordinate patient care and authorization requirements. You will communicate with insurance carriers and providers through web-based tools, electronic systems, phone calls, and fax correspondence to secure approvals and ensure accurate documentation in the patient's medical record.
You will also manage a high volume of inbound and outbound phone calls, maintain ongoing communication with internal departments, coordinate appropriate paperwork and insurance verification, and perform other clerical and administrative duties as needed to support efficient patient access and care delivery. Patient Access Insurance Specialist
Update system records after validating new patient financial information. Obtain accurate insurance information and communicate effectively with patients and physician office staff. Use Cerner databases to locate and retrieve scheduled patients for admission and registration within the Access Management Office.
Generate PHS and SurgiNet reports to support verification of scheduled procedures. Educate patients regarding the need for pre-certification with their insurance carrier to maximize coverage under their insurance policy. Verify and document insurance coverage using online eligibility systems, internet resources, and telephone communication.
Validate medical necessity through the Cerner Medical Necessity Checker, when applicable. Audit Medicare Secondary Payer (MSP) questionnaires to ensure all required fields are completed. Refer patients to Financial Counselors or Eligibility Specialists to secure appropriate payment arrangements or financial clearance, and assist in obtaining additional patient information and insurance documentation.
Verify insurance coverage by contacting insurance companies or utilizing online eligibility systems to determine available benefits. Obtain verification of benefits (VOB) information, including co-payments, co-insurance, deductibles, deductible balances, family deductibles, out-of-pocket maximums, and rehabilitation benefits. Utilize insurance eligibility software, place calls to insurance carriers, and submit authorization requests as needed.
Accurately document all VOB information within the appropriate system. Obtain pre-certification details from insurance carriers, including authorization requirements and status. Secure authorization for ancillary services, surgeries, outpatient testing, procedures, and admissions.
Collaborate with physician offices, Surgery Scheduling, and Centralized Scheduling to reschedule procedures that have not received the required authorization. Ensure medical necessity requirements are met by validating CPT and ICD-10 codes against physician orders. For government payors, review CPT codes against the Medicare Inpatient Only Procedure (MIPO) list and verify appropriate scheduling and authorization requirements.
Document authorization information and release patient accounts when pre-certification requirements have been satisfied. Initiate authorizations for direct admissions, emergency admissions, and emergency procedures. Ensure authorizations received from referring facilities are accurate and complete.
Identify out-of-network insurance plans and follow established out-of-network policies and procedures. Prepare Indiana Medicaid/HIP Universal Prior Authorization forms for Utilization Review. Maintain accurate worklists and documentation.
Upload demographic information to payors as requested. Prepare patient statistics and reports related to demographic completion rates and other requested metrics. Generate reports necessary for benefit verification and assist with bill edit report review and resolution.
Release patient accounts to support timely and accurate claims filing. Calculate and communicate co-payments and co-insurance amounts, verbally or in writing, as requested by insurance carriers. Process benefit verification and authorization requests efficiently and accurately.
Answer incoming calls and communicate information professionally in accordance with Beacon standards, departmental policies, and procedures. What You Bring As an Insurance Verification Authorization Specialist, you'll bring strong organizational, customer service, and technical skills to support the verification of insurance benefits and authorization requirements for patient services. You are proficient in using office technology and healthcare information systems, including data entry, word processing, spreadsheets, and multiple healthcare databases, while maintaining a high level of accuracy and attention to detail.
You possess a thorough understanding of medical terminology, private insurance coverage, managed care plans, insurance networks, ICD-10 and CPT coding, and time-of-service collections. You understand the importance of insurance verification, benefits coordination, and authorization processes, and can effectively communicate these requirements to patients, insurance carriers, physician offices, and other healthcare professionals.
You demonstrate strong telephone and communication skills, enabling you to accurately gather and relay patient information, physician orders, referrals, and insurance details. Your interpersonal skills allow you to interact professionally, courteously, and compassionately with patients from diverse backgrounds while building positive working relationships with physicians, office staff, insurance representatives, and colleagues throughout the organization.
You are an active listener with strong customer service skills and cultural sensitivity, particularly when assisting individuals for whom English is not their primary language. You maintain strict confidentiality, exercise sound judgment, and remain composed in high-pressure situations while ensuring compliance with organizational policies and procedures. Through your professionalism, adaptability, and attention to detail, you help ensure an efficient authorization and insurance verification process that supports quality patient care and financial clearance.
Required Qualifications Associate's degree preferred. A minimum of two years of experience in a hospital or physician practice business office is required. Excellent time management, organizational skills, research/analytical skills, negotiation, communication (written and verbal), and interpersonal skills are required.
A medical terminology course must be successfully completed prior to employment. Medical prior authorizations or claims experience in a managed care setting is highly preferred. CHAA certification is highly preferred.
Day shift · 0830-5pm M-F
About the role
As a Patient Access Insurance Specialist, you'll report to the Patient Access Director or Insurance Specialist Supervisor and play a key role in ensuring patients receive timely access to covered healthcare services. You will verify insurance coverage, obtain required authorizations, pre-certifications, and approvals for procedures, diagnostic testing, admissions, and hospitalizations before services are rendered.