Insurance Benefit Coordinator

Insurance Benefit Coordinator Affiliate Wide (Rochester, Syracuse, or Buffalo, NY areas)

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.

In support of PPCWNY’s mission, the Insurance Benefits Coordinator (IBC) has responsibility for coordinating and supporting initiatives related to the evaluation, processing, and handling of Presumptive Medicaid (PEP/MAPE), Presumptive Eligibility Family Planning Benefit Program (PEFPBP), and Family Planning Benefit Program (FPBP) applications from all sites. The IBC works collaboratively with all Health Center teams to identify potentially eligible uninsured or underinsured patients and pregnant women to determine eligibility for specific state‑sponsored FPBP and Presumptive health insurance programs, and works individually with identified patients, as needed, to ensure timely submission of applications and required documentation.

The IBC tracks enrollment progress, compiles data, establishes and monitors goals for the team, serves as support for day‑to‑day questions and training, and provides education to front desk staff across Shared Services. The IBC ensures consistency across all affiliates.

This position has responsibility across three NYS affiliates through Shared Services, including Planned Parenthood of Central and Western New York, Upper Hudson Planned Parenthood, and Planned Parenthood of the North Country.

• For patients seen personally by the IBC, completes the full cycle of identification, enrollment, submission, and follow‑up for patients eligible to be enrolled in appropriate government benefit programs
• Ensures accuracy and completeness of applications taken by other center staff and assists patients and/or center staff in any manner required to fulfill the application submission requirements
• Represents the client in the application process and serves as liaison between the affiliate and the appropriate governmental entity
• Processes applicants’ recertification, terminations, and other inquiries from each Local Department of Social Services (LDSS) including determinations of ineligibility for processing errors by the LDSS
• Compiles 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

• Monitors 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,…