Patient Access Insurance Specialist, Verification of Benefits Department, Full-Time Days

Beacon Health System is hiring a full-time day Patient Access Insurance Specialist, in our Verification of Benefits Department at Beacon Health System in South Bend, 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.

• 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 will report to the Patient Access Director or the Insurance Specialist Supervisor. Follows established Beacon policies and procedures to verify insurance coverage to ensure necessary procedures and hospitalizations are covered by an individual's provider. The Insurance Verification Authorization Specialist will assure authorization is obtained for all procedures and diagnostic testing to services being rendered. The Authorization Specialist will also initiate the authorization for direct admissions, emergency admissions, and emergency procedures. They will work closely with medical staff, clinical staff, referring clinics, Beacon Outpatient Scheduling Surgery Scheduling, Social Services, and Utilization Review departments. They will be responsible for communication with insurance carriers and/or providers for purposes of obtaining approval for services requiring authorization, pre-certification, and prior approval for admissions to Beacon or Epworth Center by using web-based tools, other electronic means where possible, or by telephoning and faxing when necessary. Coordinating those visits with the correct paperwork and insurance verification, along with accurate documentation in the patient's medical record is essential. They will answer high volume of incoming phone calls as well as making high volume of outbound phone calls, with constant communication to the Utilization Review, Social Services, Beacon Outpatient Scheduling and Surgery Scheduling departments. Performs other clerical duties as necessary.

Patient Access Insurance Specialist Job Responsibilities:

• Verify and update patient demographic and financial information to ensure accuracy in the registration system.
• Obtain and validate insurance coverage using online eligibility systems, payer portals, and telephone verification.
• Utilize Cerner systems and reports (e.g., PHS, SurgiNet, Medical Necessity Checker) to review scheduled patients, procedures, and medical necessity requirements.
• Audit and complete required documentation, including MSP questionnaires and insurance verification records.
• Coordinate verification of benefits (VOB) by confirming co-pays, deductibles, coinsurance, out-of-pocket limits, and rehabilitation benefits with insurance providers.
• Secure and document pre-authorizations and pre-certifications for ancillary, surgical, outpatient, and inpatient procedures.
• Collaborate with physician offices, scheduling teams, and referring facilities to ensure required authorizations are obtained and procedures are properly scheduled.
• Validate CPT and ICD-10 codes and confirm compliance with Medicare Inpatient Only Procedure (MIPO) requirements when applicable.
• Identify out-of-network insurance plans and follow established policies and procedures.
• Refer patients to Financial Counselors or Eligibility Specialists when financial clearance or payment arrangements are required.
• Maintain accurate worklists, documentation, and records to support timely claim submission and reimbursement.
• Calculate and communicate estimated patient financial responsibility, including co-payments and coinsurance.
• Prepare reports, patient statistics, and documentation to support departmental operations and leadership requests.
• Provide professional customer service by answering calls, communicating with patients and internal departments, and maintaining positive patient relations.
• Collaborate with departments such as Utilization Review, Surgery Scheduling, Social Services, and Outpatient Scheduling to ensure accurate and timely patient processing.
• Support departmental quality goals by maintaining productivity, accuracy, and compliance with Beacon policies and procedures.
• Maintain professionalism while representing Beacon Health System and perform other duties as assigned.

What You Bring

As a Patient Access Insurance Specialist, it requires strong office and computer skills, including keyboarding (minimum 40 wpm), data entry, and proficiency with systems such as Cerner, Pathways Healthcare Scheduling, Experian, and MCA Compliance Checker. Demonstrates knowledge of medical terminology, insurance coverage, managed care networks, ICD-10 and CPT codes, and time-of-service collections, including the ability to clearly communicate financial responsibilities to patients. You will possess strong telephone, verbal communication, and listening skills to effectively interact with patients, insurance companies, physicians, and internal departments. You will maintains professionalism and sensitivity when working with diverse populations, follows strict confidentiality policies, exercises sound judgment in stressful situations, and applies basic math skills to calculate patient financial responsibilities such as deductibles, coinsurance, and out-of-pocket costs.

Required Qualifications

• The knowledge, skills and abilities as indicated below are normally acquired through the successful completion of a high school diploma (or equivalent).
• 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 required.
• A medical terminology course must be successfully completed prior to employment.
• Associate's degree preferred.
• Medical prior authorizations or claims experience in a managed care setting and CHAA certification are highly preferred.

The Beacon Way

At Beacon Health System, our approach to care goes beyond clinical excellence because it’s built on meaningful connections. Guided by our core values of Trust, Respect, Integrity, and Compassion, we strive to create an environment where patients feel heard, employees feel valued, and innovation thrives.

We call this commitment The Beacon Way—a six-point operating system that empowers every team member to lead with purpose, communicate clearly, cultivate talent, embrace performance improvement, leverage innovation, and build greatness through accountability. Whether at the bedside or behind the scenes, everyone at Beacon plays a role in moving health forward.