Planned Parenthood of the Pacific Southwest is seeking Patient Access Specialists! 

Bilingual Required

Planned Parenthood of the Pacific Southwest is one of the largest providers of reproductive healthcare in Southern California, operating 19 health centers and growing! We are proud to announce primary care services will soon be available in San Diego! Planned Parenthood of the Pacific Southwest has been voted one of the best places to work.

Care. No matter what.

Please visit http://news.planned.org/ for more information on our amazing affiliate.

The Patient Access Specialist role is an exciting new opportunity at our affiliate. Responsible for all aspects of registering patients, verifying insurance, and maintaining a positive patient experience, this role is a great place to expand your knowledge of the healthcare industry!

Education and Experience:

High School diploma equivalent.

-and-       

1 year admitting/registration, 1 year PPPSW healthcare experience, or equivalent healthcare experience required.

Demonstrated experience with referral authorization process.

Working knowledge of insurance industry concepts such as HMO’s, PPO’s, copays, deductibles, coinsurance, healthcare exchanges/ACA, etc.

Working knowledge of medical billing concepts such as ICD-9, ICD-10, CPT4

Essential Functions

Essential functions encompass the required tasks, duties, and responsibilities performed as part of the job and the reason the job exists.

  • Responsible for the accuracy of patient and insurance information entered into the Agency’s Practice Management system.
  • Researches issues involving patient demographics and insurance eligibility.
  • Verify insurance eligibility, benefits, and patient share of cost for certain office visits and procedures with 3rd party and governmental payers upon scheduling of patients
  • Obtain pre-authorizations as required by 3rd party insurance and governmental payers
  • Negotiates payment plans for patients who cannot afford payment in full using agency established parameters. 
  • Performs financial counseling with patients to ensure they are aware of their insurance coverage and financial responsibility. 
  • Serves as a patient advocate ensuring they are aware and take advantage of all governmental programs such as Medi-Cal, PE, Family PACT, etc as well as sliding fee discounts based on family size and income.
  • Schedule appropriate family planning and surgical appointments.
  • Registers patients, compiling complete and accurate information for Health Center records and timely reimbursement.
  • Reconciles billing at the end of patient visit.
  • Responds to Billing Department, Patient Access, and Call Center inquiries and responds effectively to questions and concerns expressed by patients and other staff.
  • Manages in person medical record release request and scanning processes.
  • Ensures appointments conform to established authorizations.
  • Accurately prepares end of day reports for Health Center Manager review.
  • Resolves problems (registration, eligibility, billing or financial) in a timely manner.
  • Accepts and processes payments transactions according to established guidelines.
  • Appropriately refers patients to correct agencies or offices for service(s).
  • Appropriately schedules surgery and procedures in a timely manner according to patient and physician schedule.
  • In support of PPPSW’s Just Culture Philosophy, identify and report errors, near misses, and employee, patient and customer safety concerns in a timely manner.   
  • To support risk and quality management by proactively communicating identified risks to supervisor in order to minimize risk when possible.
  • Comply with PPPSWs Code of Conduct and maintain the highest level of professional and ethical standards and to act in compliance with both the letter and spirit of all applicable laws and regulations.