Patient Access Specialist - Mission Bay

Mission Bay, CA
Medical Services & Center Operations – Clinical/Medical
Full Time
Planned Parenthood of the Pacific Southwest has been voted one of the best places to work. We are one of the largest providers of reproductive healthcare in Southern California, operating 18 health centers throughout our three county region. Check out our new video, "We are Planned Parenthood of the Pacific Southwest” for more information about our organization: https://youtu.be/2ATarFSN3TQ.

Care. No Matter What.

We are searching for a superstar Patient Access Specialists for our Mission Bay Health Center

As a Patient Access Specialist you will serve our patients in a meaningful way. A dynamic role that allows you to interact with more than 40+ patients a day. You will be "on stage" at all times and will be the initial face of the health center - the welcome introduction to Planned Parenthood of the Pacific Southwest.

This role will be responsible for the following:

- Interacting with patients to gather information for accurate registration and scheduling appointments
- Insurance eligibility verification's
- Having positive interactions with patients and making sure they receive the care they need

This is a Full Time - Benefits Eligible position located in Mission Bay in San Diego, CA. This position requires 2 Saturday rotations per month.

Compensation is $18.50/hour to $19.00/hour

Qualifications:

    • 2 years of customer service experience
    • OR
    • 1 year of admitting/registration experience at the front desk in a healthcare environment
    • OR
    • Bachelor’s degree and the willingness to learn how to perform accurate registration and scheduling, medical terminology, insurance verification, payment collection and billing. Must be passionate about providing excellent customer service to all Planned Parenthood patients in a non-judgmental, empathetic manner.

Essential Functions

    • Understand, interpret, analyze, problem solve, and explain to patients payer contracts, referral and authorization restrictions, and patient payment responsibility. 
    • Negotiate payment plans for patients who cannot afford payment in full using agency established parameters. 
    • Reconcile billing and ensure check-out procedures happen in real time before patient exits health center.
    • Accept and process payment transactions according to established guidelines.
    • Help to refer patients to correct agencies or offices for other service(s).
    • Schedule follow up appointments in a timely manner according to patient and provider schedules.
    • Prepares clean claims for electronic adjudication.
    • Manage scanning processes.
    • Accurately prepare end-of-day reports for Health Center Manager’s review.
    • Essential functions integrated from PAS I role
    • Provide exceptional customer service with every patient, every time they come into the health center.
    • Greet patients and communicate expected wait times and walk-in appointment availability.
    • Communicate with back office regarding walk-in demand and wait time issues.
    • Use service recovery techniques to ensure patients’ experience is optimal.
    • Accurately enter patient demographics and insurance information into the Agency’s Practice Management system.
    • Research 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-authorization as required by 3rd party insurance and governmental payers.
    • Perform financial counseling with patients to ensure they are aware of their insurance coverage and financial responsibility. 
    • Serve 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 family planning and specialty services appointments for patients and ensure appointment conforms to established authorizations.
    • Develop and apply knowledge of complex medical insurance terminology.
    • Respond to Patient Accounts Department, Insurance Authorization Department, and Contact Center inquiries, and respond effectively to questions and concerns expressed by patients and other staff.
    • Resolve problems (registration, eligibility, billing or financial) in a timely manner.
    • 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.

Non-Essential Functions

    • Ensure compliance with all regulatory requirements (e.g. annual TB Testing, biannual review of emergency policies, procedures and drills, annual OSHA training review etc.) per Agency policy and regulatory mandates.
    • Attend training, staff meetings and in-services to maintain and increase knowledge of protocols and procedures.
    • Assist in training of new staff and volunteers by demonstration and observation of techniques and procedures.
    • Perform clerical and administrative duties as directed by Center Manager.
    • Other duties and responsibilities as assigned.
*Loc=San Diego
*Ref=500

We are the power of Planned Parenthood.

We are Planned Parenthood of the Pacific Southwest, one of the largest and most prominent affiliates of the most iconic health care organization in the world. We are recognized for the wide array of services we provide and the outstanding education we deliver.

We are a prominent and powerful team of health experts who work relentlessly to help our communities sustain their health and well-being. We adhere to the highest standards and protocols as we collaborate and care for people, without judgment.

100 years of advocating for our mission has secured our advancement, our future and our passion for practicing health care.

We are a team you can have fun with and a powerful movement you can be part of. Together we’ll take pride in shaping the future of sexual health and reproductive rights.

For those who feel that purpose is critical to their work, this is a gift.

In This Together.

Planned Parenthood of the Pacific Southwest is an Equal Opportunity Employer.
Please visit our careers page for more information: www.pppswcareers.org