[Hiring] Benefits Investigation & Eligibility Specialist @Baylor Genetics

Role Description

The Benefits Investigation & Eligibility Specialist verifies patient insurance eligibility and investigates benefits for genetic and molecular diagnostic testing. This role confirms active coverage, identifies patient benefit information and payer requirements, resolves missing or conflicting insurance information, and documents findings accurately so cases can move forward without avoidable reimbursement delays.

The ideal candidate is self-directed, resourceful, and able to solve problems independently while knowing when to escalate. Strong attention to detail and a patient-centered approach are required. The Specialist works with patients, provider offices, payers, and internal teams to provide clear, accurate, and timely insurance information.

Qualifications

• High school diploma or equivalent.
• 2+ years of experience in healthcare insurance verification, benefits investigation, patient access, revenue cycle, or a related function.
• Working knowledge of commercial insurance, Medicare, Medicaid, and managed care plans.
• Experience using payer portals, electronic eligibility tools, and healthcare or revenue cycle systems.
• Ability to work independently, research issues, make sound decisions within established procedures, and escalate appropriately.
• Strong problem-solving skills and the ability to resolve incomplete, conflicting, or unclear insurance information.
• Exceptional attention to detail and accuracy in data entry, documentation, and follow-up.
• Strong written and verbal communication skills with a professional, patient-centered approach.
• Ability to manage multiple cases and priorities in a production-based environment.
• Ability to handle protected health information and confidential financial information appropriately.

Requirements

• Associate degree in healthcare administration, business, or a related field.
• Experience in diagnostic laboratory, genetics, molecular diagnostics, pathology, or specialty healthcare.
• Experience with Quadax, Salesforce, clearinghouses, payer portals, or similar systems.
• Familiarity with prior authorization workflows, payer medical policies, and patient financial responsibility.

Benefits

• Location: Remote.
• Work is primarily computer- and telephone-based and frequently requires sitting, keyboard and mouse use, speaking, listening, and reviewing electronic information.
• Regular interaction with patients, provider offices, payers, and internal operational teams.
• Protect patient, client, financial, and company information in accordance with HIPAA and Baylor Genetics policies.
• Perform other job-related duties as assigned. Reasonable accommodations will be provided in accordance with applicable law.

Company Description

Baylor Genetics is proud to be an equal opportunity employer committed to fostering an inclusive and diverse workplace. We welcome and encourage applicants from all backgrounds to apply. We do not discriminate on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, age, veteran status, disability, genetic information, pregnancy, childbirth, or any other status protected by applicable federal, state, or local law. If you need an accommodation during the application process, please contact our Human Resources team.