Insurance Benefit Coordinator

Job TypeFull-time

Processes applicants' recertification, terminations, and other inquires forthcoming from each Local Department of Social Services (LDSS) including determinations of ineligibility for processing errors by the LDSSCompiles monthly statistics to reflect the current status of applications received, processed, and finalized Attains the goal of number of new enrollees and reinstatements on a consistent basis as determined by Health Center Operations and Finance through the annual budgeting process Trains and evaluates health center staff on enrollment processes in collaboration with the Health Center Manager and Revenue Cycle Trainer Implements new programs or existing programs which can assist patients in obtaining insurance coverage for services Verifies patient insurance coverage to ensure necessary visits/procedures are covered by the payer; this is to include a review of high-ticket items to ensure any necessary prior approvals have been received Inputs accurate data to ensure that the patients benefit information is updated in the organization's insurance systems, and verifies that existing information is correct to track and evaluate all aspects of the screening and enrollment process Works with patients to explain coverage amounts provided by their insurance policy and discuss financial obligations and payment options when necessary Assists in obtaining necessary Medicaid or health program eligibility documents Handles application status inquiries from sites Serves as support for day-to-day questions and training and provides education to front desk staff across Shared Services as needed Works flexibly and cooperatively under supervision with all members of the health center staff to ensure maximum knowledge and support of the client Insurance Follow-upMonitors status of all outstanding applications; follows-up on pending or incomplete applications in a timely manner Responsible for timeliness, accuracy, and completeness of documentation on patient accounts and follows-up with DSS and patients regarding enrollment status (i.e., CIN numbers, benefit cards, prescriptions, etc.)Processes all FPBP communications received Acceptance/Denials: enters all necessary insurance information in NextGen and notify the Billing Department of billable Date of Service (DOS), contact patient and document in NextGenRenewals: contacts patients, documents in NextGen, and checks for past DOS for billing and notify the Billing Department as necessary Discontinuation: completes notes in NextGen system and deactivates insurance by date specified on letter Customer Service Builds and maintains positive, quality relationships with customers both internal (colleagues) and external (patients, clients, donors etc.)Demonstrates commitment to exceeding customer expectations at every opportunity Responds positively to customer Other Accountability Activities Participates in Department of Health (DOH) training and other educational opportunities to keep current on regulations, requirements and processes Participates in affiliate initiatives Participates in and adheres to agency's Compliance, Quality and Risk Management (CQRM) program Performs other duties as assigned Performs all functions in a manner that upholds Planned Parenthood of Central and Western New York (PPCWNY)'s mission, vision and values, as well as demonstrates commitment to providing services to a diverse range of clients

Certified Application Counselor (CAC) designation; certification must be obtained within six months of job acceptance (or at time of exam offering) if the candidate is not certified at the time of offer, registration for course work will be initiated immediately based on discussions with hiring manager. Knowledge, Skills, & Abilities Knowledge of insurance guidelines and government programs (i.e., Medicaid) Must be proficient in Microsoft Office (i.e., Excel, PowerPoint and Word) Strong analytical and problem-solving skillsMust demonstrate sensitivity toward patient's financial and clinical needs, while maintaining the patient's confidentiality Must be organized, able to prioritize tasks, and handle multiple projects Accuracy and attention to detail is essential Must be able to work independently and as a team player Must be able to multi-task and work in a fast-paced environment Exceptional communication skills (verbal and written) and interpersonal skillsMust be able to multi-task and work in a fast-paced environment. Must be able to work a flexible schedule to support meetings and activities and travel to other sites Must have reliable transportation Planned Parenthood seeks candidates who are proficient in two or more languages

This is a full-time, 40 hour a week, position; regular schedule will be Monday - Friday with occasional evenings and weekends.