Patient Insurance Liaison

Description

Planned Parenthood of Central and Western New York (PPCWNY) protects and provides health care and education that empowers individuals and families. With respect. Without judgment. No matter what.

Diversity and inclusion are core values at Planned Parenthood of Central and Western New York (PPCWNY). PPCWNY recruits exceptional and diverse staff. PPCWNY strives to develop staff into leaders for a diverse and global workplace.

In support of Planned Parenthood of Central and Western New York (PPCWNY)’s mission, the Patient Insurance Liaison performs the relevant Revenue Cycle clerical functions to prepare patient accounts for Front Office staff including resolution of issues to ensure timely and accurate billing workflow processes. Follows up on accounts that require further evaluation. Collaborates with staffs in Health Services and Revenue Cycle to facilitate a team environment, assisting patients to understand and fulfill their financial responsibilities and maximizing revenue.

• Reviews upcoming appointments to ensure accurate patient information and financial responsibility for Revenue Cycle billing
• Works directly with patients to obtain and clarify information, to evaluate, identify and offer funding opportunities that assist the patient with covering the cost of service, and/or provides direction for Patient Services Specialist/Health Center Associate regarding information needed from the patient
• Identifies and researches other primary insurances using verification resources and complete Patient Insurance Authorization form, or makes notes to alert front office that patient signature is needed to bill or waive primary insurance(s) found
• Assesses and documents patient responsibility for copay/deductible/coinsurance amounts based on eligible coverage(s) for visit type before patient arrival
• Researches and identifies discrepancies with insurance eligibility in the PM system
• Contacts insurance plans on behalf of patients to identify benefit details based on visit type
• When required, obtains, and documents prior authorization, or prepares patient waiver/non-covered services form for Front Office to complete with the patient
• Understands the guidelines for programs that provide sliding fee discounts and NYS or private funding opportunities offered through Planned Parenthood
• Evaluates and documents patient eligibility, informs patients of potential discounts when possible and/or makes notes to facilitate Front Office follow through on enrollment(s)
• Reviews, adds and/or updates chart Alerts; expires old Alerts
• Assists Front Office and Call Center staff in understanding insurance eligibility, coverage, benefits, and patient responsibility
• Responds to questions from patients, staff and insurance companies
• Engages in effective communication with patients, staff, and insurance companies via phone, fax, websites, and email
• Addresses concerns in a prompt, courteous, confidential, and caring manner utilizing PPFA service standards
• Participates in the development and communication of Standard Operating Procedures (SOP’s) for key areas to improve accuracy and understanding of processes
• Maintains a clean and organized work area, ensuring patient confidentiality according to HIPAA compliance regulations

Other Accountability Activities

• Provides excellent customer service to all patients and visitors and maintains confidentiality; with the intent of exceeding expectations
• Participates in and adheres to agency’s Compliance, Quality and Risk Management program
• Attends and participates in staff meetings; may assist with educating staff or attending training workshops, as requested
• Participates in affiliate initiatives
• Accepts individual and joint responsibility for, participate in, and work to achieve productivity, customer service, and capacity goals as set by the affiliate
• Performs other duties as assigned
• Shows respect to all internal and external customers for differences in backgrounds, lifestyles, viewpoints and needs in areas such as race, gender, ethnicity, creed, sexual orientation and others

Requirements

Applicants must possess the following qualifications (or equivalent combination of education and experience):

Education—

• High School Diploma or GED

Experience—

• A minimum of three years’ experience in healthcare and/or medical billing required; experience in customer service desirable

Knowledge