Spec, Insurance Discovery

This is where your work makes a difference.

At Baxter, we believe every person—regardless of who they are or where they are from—deserves a chance to live a healthy life. It was our founding belief in 1931 and continues to be our guiding principle. We are redefining healthcare delivery to make a greater impact today, tomorrow, and beyond.

Our Baxter colleagues are united by our Mission to Save and Sustain Lives. Together, our community is driven by a culture of courage, trust, and collaboration. Every individual is empowered to take ownership and make a meaningful impact. We strive for efficient and effective operations, and we hold each other accountable for delivering exceptional results.

Here, you will find more than just a job—you will find purpose and pride.

The Spec, Insurance Discovery provides direct support to the Revenue Cycle Management Department, which includes Reimbursement Services, Cash Application, Patient Account Specialist, Billing and Collections. This position is required to collaborate cross‑functionally with other Cardiology healthcare teams to coordinate and align in our mission statement of Saving and Sustaining Lives. The Spec, Insurance Discovery position requires use of data analysis tools and reporting, along with comprehensive understanding of the revenue cycle process, to analyze and resolve patient files that did not follow the standard reimbursement process.

Additionally, this position will work with the management team to identify process and procedure gaps, to ensure maximum reimbursement potential.

• Investigate and resolve complex reimbursement issues by developing strategies to return patient accounts to the reimbursement process through prior authorizations, insurance updates, or claim resolution.
• Conduct detailed account research to identify reimbursement barriers, document findings, and recommend corrective actions.
• Verify and update patient demographics, insurance information, and supporting documentation to ensure accurate claim processing and reimbursement.
• Monitor, troubleshoot, and follow up on claims, authorizations, and billing exceptions to reduce delays and improve reimbursement outcomes.
• Analyze revenue cycle and claims reports to identify trends, ensure compliance with reimbursement procedures, and determine appropriate next steps for accounts.
• Develop payer‑specific reimbursement strategies and identify trends to proactively address coverage and payment challenges.
• Collaborate with patients, caregivers, sales teams, healthcare providers, and internal stakeholders to obtain information and support reimbursement efforts.
• Deliver exceptional customer service while maintaining productivity, regulatory compliance, cross‑functional partnerships, and continuous knowledge development.

• High school diploma or equivalent required, associate’s degree or higher preferred.
• 2+ years of healthcare related experience in the revenue cycle process with a specialized focus around eligibility and benefit verification, claims submission. Cardiology related experience a plus.
• Knowledge of insurance industry and third‑party payer processes
• Excellent data entry skills required
• Ability to organize and prioritize workload
• Strong attention to detail while balancing high volume data entry
• Proficiency in Microsoft Office software
• Knowledge of Federal, State, and Local regulations, guidelines, and standards, including a working knowledge of HIPAA rules and regulations.
• Third‑party payer experience strongly preferred.
• Experience with medical record reviews to identify and ensure medical necessity preferred
• Excellent customer service skills. The ability to deescalate conflict effectively and quickly as it arises, a plus.
• Strong critical thinking and problem‑solving skills.

Baxter is committed to supporting the needs for flexibility in the workplace. We do so through our flexible workplace policy which includes a minimum of 3 days a week onsite. This policy provides the benefits of connecting and collaborating in‑person in support of our Mission.

We understand compensation is an important factor as you consider the next step in your career. At Baxter,…