Insurance Verifier - Los Angeles, Ca

Our Ideal Candidate will have the following qualifications:

• If using a personal vehicle to drive for work purposes, a valid CA driver license and current auto insurance in compliance with the minimum requirements of CA vehicle code are required.
• One (1) to two (2) years admitting/registration or equivalent healthcare experience preferred. Prior Insurance Verification experience preferred.
• Ability to work well independently.
• Knowledge of Health Care plans. Experience with Passport OneSource and Medi-HMO plans a plus.
• History of and currently exhibits excellent customer service skills.
• High School Diploma or GED required.
• Reliable means of transportation for onsite and off-site work.
• Bilingual English/Spanish required.
• Knowledge of ICD-10 and CPT codes.
• Effective use of diplomacy and candor with highly trained professionals.
• Ability and willingness to travel within Los Angeles County.
• Highly effective written and verbal communication skills.
• Demonstrated ability to work effectively and efficiently with nursing staff for scheduling and clinical feedback.
• Experience with NextGen and EPM a plus.
• Demonstrated experience with referral authorization process.
• Ability to recognize and maintain confidentiality.
• Proficient in Microsoft Word, Excel, Outlook and PowerPoint.
• Ability to demonstrate PPLA’s Service Standards.
• Knowledge of medical terminology and general knowledge of third party payors.
• Ability to ensure proper billing or financial procedures for patients.

About the position:

• Follow up with patients in regard to their benefits and approved services.
• Accurately inform health center staff on scheduled patients’ benefits (coverage vs. no coverage).
• Knowledge of various programs used to verify eligibility and benefit information.
• Maintain an accurate database of information.
• Accurately verify insurance coverage, including medical group eligibility.
• Perform other duties and special projects as assigned by Director, Revenue Cycle and Insurance Verification.
• Ensure department adheres to established program, insurance or contract standards.
• Ensure accurate and appropriate insurance and benefit information is submitted consistently.
• Primary contact with health center for Insurance verification questions.
• Problem solve any discrepancies regarding eligibility, billing and benefit verification in a timely manner.
• Keep Lead Insurance Verifier informed of issues, trends and other items that may impact Patient Services.
• Update and correct authorizations from contracted medical groups.
• Compile data in timely manner to ensure prompt turnaround time.
• Review insurance benefits and financial status with patient to determine necessary payments.

Generous salary and benefits package includes:

• Free basic life/AD&D policy with additional voluntary coverage options
• Short Term Disability, Critical Illness and Accident policies
• Medical and Dependent Flexible Spending Account plans
• Public Transportation and Commuter Pre-Tax Reimbursements
• 403(b) Retirement plan with up to 3% employer match
• Hiring Range: $24.00 - $26.40 per hour (Non-Exempt)
• Generous vacation, sick, and holiday benefits
• Medical, dental, and vision coverage options for you and eligible dependents