Insurance Verification Specialist

Insurance Verification Specialist

ABOUT PPTNM

Planned Parenthood of Tennessee and North Mississippi is one of Tennessee's oldest and largest private, non-profit health care agencies. For over 75 years, PPTNM has remained committed to providing high-quality, affordable reproductive services and education throughout Tennessee, north Mississippi, and parts of Arkansas and Kentucky. We have four health center locations in Tennessee: Memphis, Nashville and Knoxville.

Our mission is to improve health and well-being by providing high-quality, nonjudgmental sexual health care, honest and accurate sexuality education, and reproductive health and rights advocacy.

COVID VACCINATION REQUIREMENT FOR CANDIDATES SEEKING EMPLOYMENT:

PPTNM, as both a healthcare provider and a participant of Medicare/Medicaid, is subject to certain laws, regulations and orders requiring its workforce to be fully vaccinated against COVID-19 and its variants. PPTNM has therefore implemented a requirement that all employees be fully vaccinated. Candidates seeking employment with PPTNM will be required to: (1) be fully vaccinated against COVID-19 and its variants by their start date. Reasonable accommodations will be considered on a case-by-case basis for exemptions to this requirement in accordance with applicable law, and (2) submit proof of vaccination by their start date as a condition of employment with PPTNM.

JOB SUMMARY

Under the supervision and direction of the Revenue Cycle Director, the Insurance Verification Specialist provides insurance verification for insured patients; informing them of financial obligation at time of service and when prior authorization or referrals are required; responds to all internal and external phone calls regarding patients’ insurance verification inquiries.

ESSENTIAL FUNCTIONS:
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Responsible for ensuring external and internal telephone calls/Epic Secure chat messages are answered in a professional and timely manner in accordance with department policies, procedures and performance goals.
• Verifies patient’s insurance for eligibility and benefits utilizing one of the following methods as appropriate: RTS, payer’s website, and phone.
• Patients are called to inform them of their financial obligation at the time of service.
• Same day, walk in, and future insurance appointments are verified for eligibility and benefits.
• Works closely with health center and call center staff to assist in identification of patient responsibility. Identifies accurate patient portions in order to collect money at the time of service (including past due account balances).
• Perform other duties as assigned

JOB REQUIREMENTS:

EDUCATION: High School Diploma or GED; Associates Degree or equivalent from a two-year college or technical school preferred

EXPERIENCE: 2-5 years of insurance experience with current knowledge of Current Procedural Terminology (CPT) and International Classification of Diseases and Health Care Procedure Coding System (ICD-10) knowledge.

KNOWLEDGE, SKILLS, AND ABILITIES FOR THIS POSITION:

• Alignment with the mission and values of Planned Parenthood.
• Able to demonstrate behaviors that represent the Affiliate’s Workplace Values.
• Proficiency in MS Office and EMR/EHR system (Epic preferred)
• High degree of accuracy, attention to detail and confidentiality
• Excellent data entry skills
• Effective verbal, listening and written communication skills
• Effective organizational, stress and time management skills
• Demonstrates a sense of urgency and ability to meet deadlines
• Ability to work independently or as a team member
• Consistently interacts positively with internal and external customers
• Ability to sit at a desk in front of a computer for extended periods of time
• Knowledge of insurance terminology and deciphering benefit information

COMPENSATION/BENEFITS PROGRAM:

• Competitive base salary commensurate with experience
• 100% Employer paid Medical, Dental, Basic Life/AD&D, STD, LTD (Employee Only Coverage)
• Voluntary Vision, “Buy-Up” options on Basic Life, Spouse, & Dependent
• 401(k) plan with matching opportunity
• Plum Benefits & Pet Insurance
• Starting PTO of 15 vacation days within first year (pro-rated based on start date), 2 Floating Holidays and 10 Paid Holidays

This job description is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with this position. While intended to be an accurate reflection of the current job, management reserves the right to review and change this description as needed to maintain business goals and accomplishments. Job descriptions are reviewed periodically. This job description is not a contract.

NON-DISCRIMINATION STATEMENT/ACKNOWLEDGEMENT:

Planned Parenthood of Tennessee and North Mississippi does not discriminate on the basis of race, color, religion, sex, sexual orientation, national origin, age, marital status, veteran status, citizenship, disability, atypical hereditary cellular blood trait, genetic predisposition or carrier status or any other characteristic protected by applicable law. PPTNM will make reasonable accommodations in compliance with Section 504 of the Rehabilitation Act of 1973; the Americans with Disabilities Act of 1990; and any subsequent revisions or additions to related law/regulations.

E-VERIFY PARTICIPATION:

PPTNM participates in E-Verify and will provide the federal government with your form I-9 information to confirm that you are authorized to work in the U.S.