Job Description
Planned Parenthood California Central Coast (PPCCC) values diversity, equity, and inclusion. We believe we are most impactful when people with a wide range of backgrounds, experiences, and identities come together with common purpose. We are committed to advancing health equity in communities along the Central Coast and we are taking focused steps to become an organization where every person feels a genuine sense of belonging.With this focus, we strongly encourage Black, Indigenous and People of Color (BIPOC) and members of the LGBTQ+ community to apply and help serve the needs of our communities.PPCCC is a trusted provider of high-quality, affordable reproductive health care along California’s Central Coast. Each year, PPCCC provides 35,000 people on the central coast with health care services; including sexually transmitted infection testing and treatment, birth control, breast and cervical cancer screenings, vasectomies, and safe and legal abortion care at our six health center locations. PPCCC also provides comprehensive sexuality education programs to help adults and teens make healthy decisions, prevent unintended pregnancies, and avoid sexually transmitted infection.
JOB SUMMARY: Process insurance billings, rebills, corrected claims, appeals, and answer daily correspondence from insurance payers and patients. Import and post electronic and paper remittances, and edit and monitor contractual adjustments. Perform collection duties: create and monitor aging reports, follow up on returned mail, and other general account maintenance. Assist billing team as needed with other daily/weekly/monthly functions such as generating statements, and maintaining filing systems and billing records.
ESSENTIAL FUNCTIONS:- Investigates denials and completes applicable forms (e.g. appeal requests or prior authorizations, patient self-reporting claim form); writes letters and/or appeals; and provides copies of records, Explanations Of Benefits, or other information to patients or insurance carriers to resolve claims or outstanding balances as needed.- Reviews and monitors outstanding insurance balances in a timely manner. Contacts insurance companies regarding the status of payments. Monitors coordination of benefits. Resubmits claims as necessary. Researches and requests refunds as appropriate.· Complete correspondence from Insurance payers and patients in a timely fashion.- Assists billing team as needed with other daily/weekly/monthly functions such as generating statements, and maintaining filing systems and billing records.· Other duties as assigned
QUALIFICATIONS: - Knowledge of health insurance procedures and systems.· Familiarity with NextGen Practice Management Application.· Knowledge of ICD-10, medical terminology, and medical coding.· General office experience.· Experience with Nextgen Practice Management Application is desirable.· Minimum 1 year of healthcare experience or program.· Knowledge of FamilyPact, MediCal, and commercial billing.Planned Parenthood California Central Coast’s (PPCCC’s) compensation philosophy supports the organization’s mission,vision, and values. Each position has a salary based on market value and the organization’s pay levels. The starting salary for this position is 25.28/hour with an opportunity for an increase after six months of employment. As part of our commitment to pay equity, PPCCC does not negotiate salaries.
Job Specification