POS
POS (Point of Service) is a type of health insurance plan that combines features of both HMO and PPO plans. It gives patients more flexibility in choosing their healthcare providers while still maintaining some cost control through a network system. Think of it as a middle-ground option where people can see doctors both inside and outside their insurance network, though it's usually more cost-effective to stay in-network. When reviewing resumes, you might see this term used by professionals who have experience working with insurance plans, healthcare administration, or medical billing.
Examples in Resumes
Managed patient enrollment and benefits for POS and PPO insurance plans
Processed claims and verified coverage for POS health plans
Trained staff on POS plan requirements and procedures
Coordinated between providers and insurance companies for Point of Service plan administration
Typical job title: "Insurance Specialists"
Also try searching for:
Where to Find Insurance Specialists
Professional Organizations
Online Communities
Job Resources
Example Interview Questions
Senior Level Questions
Q: How would you handle a complex situation where a patient disputes a POS plan's out-of-network charges?
Expected Answer: A senior professional should explain the process of reviewing the claim, verifying benefits, explaining the plan's structure to the patient, and working with providers to possibly adjust charges or create payment plans.
Q: What strategies have you implemented to improve POS plan member satisfaction?
Expected Answer: Should discuss experience with educational programs, streamlining approval processes, improving communication between providers and insurance, and developing better explanation of benefits materials.
Mid Level Questions
Q: Explain the key differences between POS plans and other insurance types to a new client.
Expected Answer: Should be able to clearly explain how POS plans combine HMO and PPO features, discuss primary care physician requirements, and explain in-network versus out-of-network benefits.
Q: How do you handle prior authorization requirements in POS plans?
Expected Answer: Should explain the process of obtaining prior authorizations, common requirements, timeline management, and how to handle urgent situations.
Junior Level Questions
Q: What are the basic features of a POS health insurance plan?
Expected Answer: Should be able to explain the basic concept of primary care physician referrals, in-network versus out-of-network coverage, and common copay/coinsurance structures.
Q: How do you verify a patient's POS plan coverage?
Expected Answer: Should demonstrate knowledge of checking eligibility, understanding member ID cards, using verification systems, and confirming basic benefits.
Experience Level Indicators
Junior (0-2 years)
- Basic understanding of POS plan structure
- Verification of benefits
- Customer service skills
- Basic claims processing
Mid (2-5 years)
- Complex claims resolution
- Prior authorization management
- Provider network coordination
- Detailed benefits analysis
Senior (5+ years)
- Strategic plan management
- Policy implementation
- Team leadership
- Complex problem resolution
Red Flags to Watch For
- No knowledge of basic insurance terminology
- Lack of understanding about healthcare regulations
- Poor customer service experience
- No experience with insurance verification systems
