Patient Access Specialist
Greater San Diego, 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 bilingual (English/Spanish) Patient Access Specialists for our Health Centers in San Diego County, CA.
The Patient Access Specialist (PAS) is responsible for all aspects of scheduling and registering patients. The PAS will prepare, scan and coordinate 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, verify patient identity, schedule patient appointments at same and other health centers, and answer phones.
- High School diploma equivalent.
- 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, HCPCS, etc.
- Responsible for the accuracy of patient and insurance information entered 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
- 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.
- 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.
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