Billing Specialist

Concord, CA
Finance – Billing
Full-time
Planned Parenthood Northern California (PPNorCal) is currently seeking a full-time Billing Specialist to serve our clients at our Concord Administration Office. As an integral part of the Client Services Team, the Billing Specialist ensures errors on third party billing from system generated error reports are corrected prior to submission of claims to third party payers and works denials from third party payers in order to resubmit claims for payment.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

This is a non-exempt, full-time position, working 40 hours per week.
 
APPLICATION INSTRUCTIONS: Please include a cover letter along with a resume with your on line submission.

ESSENTIAL DUTIES AND RESPONSIBILITIES

    • Addresses billing questions to and from clinical staff regarding issues dealing with patient eligibility, data entry, coding and other payer requirements.
    • Analyzes and processes third party Remittance Advice Details and determines appropriateness of resubmitting denied claims within specific limits of payers.
    • Posts payments from third party payers.
    • Contacts insurance companies, as necessary, to resolve payment, denials and billing issues.
    • Identifies and communicates effectively in verbal and written format the errors found in the billing and reports them to the appropriate supervisor.
    • Completes claim and appeal inquiry forms to payers.
    • Works daily error reports and completes claim corrections.
    • Work aging and rebill reports, follow up on appeals to ensure payment of claims.
    • Ensure accuracy and completeness of data entered and verifies accurate billing.
    • Answer technical questions from Health Center staff regarding billing, patient eligibility and service coverage.
    • Performs a variety of clerical tasks for the billing dept., including filing, and sorting, posting or copying.

QUALIFICATIONS

    • One year medical billing certificate from college or technical school; plus minimum one year related experience and/or training (could include min. one year experience as a RHS III at PPNorCal); or equivalent combination of education and experience.
    • Experience working with practice management systems (preferably NextGen) and third party billing/coding, especially with Medi-Cal.
    • Ability to read and interpret documents such as medical billing manuals, operating and maintenance instructions and procedure manuals (NextGen).  Ability to write routine reports and correspondence.  Ability to speak effectively before groups of customers or employees of organization.
    • Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.  Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
    • Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
    • To perform this job successfully, an individual should have knowledge of database (NextGen), Internet, spreadsheet (Excel) and word processing (Word) software.
    • Demonstrated proficiency in the organization’s practice management system including the ability to be a resource for staff regarding basic trouble shooting, building profiles, triaging technical problems and utilizing resources as needed.
    • In-depth knowledge of CPT, ICD-9 and various payer sources, especially Medi-cal.
    • Acceptance and application of the confidential nature of the position.
    • 10-key proficiency by touch.
    • Strong communication (verbal and written), decision-making, time management and organizational skills.
    • Must have the willingness and ability to adapt to change including advances in technology.
    • Must have excellent customer service skills and be committed to providing the highest level of customer satisfaction.
    • Must continuously demonstrate ability to work effectively, cooperatively, and harmoniously with co-workers and others encountered in the course of the job.
    • Must be counted on to complete assigned duties. Must be punctual and maintain regular attendance with minimum number of unplanned absences.
    • High level of accuracy and attention to detail.
    • Ability to prioritize work and to manage shifting and multiple projects and priorities in a fast paced, growth environment.
    • Ability to sit and concentrate for extended periods of time.
    • Ability to work independently and as part of a team.
    • Commitment to quality health care.
Planned Parenthood Northern California is an equal opportunity employer and works affirmatively to include diversity among its staff and does not discriminate on the basis of race, color, ethnicity, religion, sex/gender identity, sexual orientation, national origin, age, disability, income, marital status or any other irrelevant dimension of diversity. PPNorCal values collaboration between employees of diverse backgrounds and experiences. 

Planned Parenthood Northern California generates healthier communities through the delivery of quality sexual and reproductive health care services.
 
We provide healthcare and education services to 136,000 adults and youth every year at 19 sites located throughout 20 Northern California counties. Planned Parenthood Northern California offers high-quality, affordable health care to all, regardless of income or insurance status. We care. No matter what!
 
Our experienced and caring medical staff gives each patient honest information and personal attention. We provide a full range of services including: birth control, breast exams, cancer screenings, medication and in-clinic abortion, pregnancy testing and counseling, prenatal care, PrEP and nPEP to prevent HIV infection, STD screening and treatment, vasectomy and infertility services, gender-affirming hormone therapy, and more.