Patient Access Specialist

Escondido, CA
Medical Services & Quality – Clinical/Medical
Full Time, 40 hrs, 5 days
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 17 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 seeking a Patient Access Specialists for our Health Center in Escondido, California.
The Patient Access Specialist (PAS) is the first person our patients see when they walk in our health centers! In addition to greeting patients with a warm and welcoming attitude, the front desk PAS role is responsible for verifying patient identity and insurance, scheduling and registering patients; preparing, scanning and coordinating paperwork; verification of payer source and patient financial responsibility prior to services, enter charges, clear claim edits, and submit claims, collect fees/receipts and donations, and answering limited amount of phone calls.

This is a dynamic role with a lot of responsibility. It requires several different types of skill sets, not the least of which is a positive and friendly, patient-focused attitude. If you love working face-to-face with patients in a high pressure, high volume environment - and you have real time insurance verification work experience - then this is the job for you!

Required Qualifications:

    • High School diploma (or equivalent).
    • 1 year of admitting/registration work experience in a healthcare facility (checking patients in & out: this type of work experience is required).
    • Demonstrated experience with insurance verification and 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, HCPCS, etc.

Job Duties

    • 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
    • Negotiate payment plans for patients who cannot afford payment in full using agency established parameters.  
    • 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 appropriate family planning and surgical appointments.
    • Register patients; compile complete and accurate information for Health Center records and timely reimbursement.
    • Reconcile billing at the end of patient visit. 
    • Respond to Billing Department, Patient Access, and Call Center inquiries, and responds effectively to questions and concerns expressed by patients and other staff.
    • Manage in-person medical record release request and scanning processes.
    • Ensure appointment conforms to established authorizations.
    • Accurately prepare end-of-day reports for Health Center Manager review.
    • Resolve problems (registration, eligibility, billing or financial) in a timely manner.
    • Accept and process payment 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.
    • 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.
*Loc=Escondido
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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