Insurance Verification Specialist

3 weeks ago


Anaheim, United States Anaheim HC, CA-ANA Full time

Planned Parenthood of Orange and San Bernardino Counties has a full-time opportunity for a Insurance Verification Specialist in Anaheim, CA.

The Insurance Verification Specialist performs detailed insurance benefit verifications while effectively communicating with the patient, and front office staff, and corresponding with a variety of insurance companies. The Insurance Verification Specialist is a part of the Revenue Cycle Management Department.

At PPOSBC, we understand the importance of a well-rounded benefits program and are dedicated to providing you with unique benefits that meet the needs of you and your family. We are proud to offer a range of plans that help protect you in the case of illness or injury including:

  • A competitive benefits package including medical, dental, and vision coverage for you and eligible dependents, life insurance, and long term disability.
  • Benefits coverage starts after one full month of employment
  • Generous vacation, sick, and holiday benefits
  • Generous 401(k) matching contributions and more
  • To view our detailed benefits guide, please visit our career site at

Responsibilities

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

  • Protect confidential patient health information (PHI) at all stages of the verification of benefits process.
  • Perform detailed verifications of benefits for patients seeking treatment.
  • Maintain extensive knowledge of different types of payer coverage and insurance policies.
  • Pays attention to detail and has great organizational skills.
  • Complete insurance verification to determine patient's eligibility, coverage, co-insurance, and deductibles.
  • Verifying any out-of-pocket or out-of-network costs for the patient.
  • Actively listens to patients and handles stressful situations with compassion and empathy.
  • Position requires staff to spend extensive amounts of time on the phone or on the payer websites with insurance companies
  • Verify insurance carriers are listed in the company's database system, if not request the new carrier be entered.

Non-Essential Functions:

  • Excellent customer service skills
  • Decision Making
  • Excellent ability to communicate both verbally and in writing.
  • Ability to prioritize and manage multiple tasks.
  • Work well independently and as part of a group.
  • Ability to adapt and be flexible in a rapidly changing environment, be patient, accountable, and proactive.
  • Other duties as assigned.

PHYSICAL REQUIREMENTS:

The physical requirements of this position are identified below. Reasonable accommodations may be made for individuals with disabilities to perform the essential functions of this position.

CORE COMPETENCIES – WE CARE:

  • Welcoming: Anticipates customer requirements and gives high priority to customer satisfaction and service. Handles problems quickly and efficiently. Maintains a pleasant, positive and professional approach. Embraces opportunities to help team members, stakeholders, and other departments.
  • Equitable: Creating equitable access and opportunity for all through education, practicing inclusive behavior, elevating others' voices, creating spaces for honest conversation, and listening without judgment. Values and uplifts our collective diversity within in our agency.
  • Confidential: Respects the information shared by our patients, employees, and vendors and maintains appropriate confidentiality. Follows all policies and laws that protect private & privileged information.
  • Accessible: Is available and approachable to others, open-minded, fair and non-defensive. Appreciates constructive feedback and is a team player. Demonstrates good listening skills.
  • Respectful: Values diversity and treats everyone with dignity and courtesy. Dependable and courteous of other people's time and commitments.
  • Empathetic: Demonstrates interest and understanding in other people's feelings, attitudes and reasoning. Maintains an open and non-judgmental demeanor that is patient, flexible, and understanding.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Minimum Education:

  • High School Diploma.

Minimum Work Experience

  • Two-year of work-related experience in healthcare administration, insurance customer service.
  • General knowledge of Medi-cal, PE, Fam Pact, Commercial, HMO's and Managed Care

Agency Standard Requirements:

  • Strong commitment to quality healthcare and excellent customer service is required.
  • Must thrive in a fast-paced, rigorous environment with changing priorities.
  • Ability to meet deadlines and work under pressure.
  • Must demonstrate high-level computer skills including; Microsoft Word, Excel and Outlook. Electronic medical records experience may also be required.

Abortion patients are cared for at each of our health centers and in part through the administrative, support, and other non-clinical services provided at all PPOSBC locations and by all PPOSBC employees, and supporting these critical services is an essential job duty and fundamental responsibility of all employees.



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