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: Responsible for ensuring timely and accurate billing is submitted to the appropriate third-party payer. This role is responsible for PPCCC’s geographic area (Thousand Oaks to San Luis Obispo) health center billing.
ESSENTIAL FUNCTIONS:- Validates charges from pending charges report, with EHR and PM systems within NextGen.- Creates claims into Rosetta holding tank for processing to Claim Remedy. - Identifies issues that need improvements and communicates with the Center Director or Clinician to ensure accurate charting and billing. - Posts payments into NextGen PM and applies funds by CPT to encounter or to the account level.- Runs weekly Nextgen reports for review and follow-up and identifying trends and accuracy.- Acts as a liaison between Patient Accounting and health center staff and patients with billing, refund, or collection questions.- Update insurance information in NextGen PM, as needed- Has a thorough knowledge of medical terminology and the ability to research missed charges.- Perform other related duties as assigned by the Revenue Cycle Director.
QUALIFICATIONS: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 essential functions.- Thorough knowledge of third-party insurance billing, including Medi-Cal, Medicare, and private insurance. - Solid understanding of CPT-4 and ICD-9/10 codes.- Working knowledge of both Electronic Health Records and Practice Management processes, preferably in using NextGen. -Strong oral and written communication skills required.- Must be detail-oriented, organized, and able to meet deadlines.- Interact with patients and employees in a professional manner- Work to ensure patient satisfaction. Establish rapport with clients, remaining cognizant of and responsive to the needs for medical and educational care delivered in a professional expedient manner.- Excellent customer service skills and commitment to providing the highest level of customer satisfaction.
EDUCATION and/or EXPERIENCE:- High School diploma or equivalent- Experience with NextGen Practice Management Application is required- Minimal 2 years billing experience in a clinic work environment- Knowledge of FamilyPACT, MediCal, and commercial billing- English/Spanish bilingual skills desirable- Must have strong computer skills, including the ability to use spreadsheet and word processing software.- Experience with NextGen Practice Management Application is required
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/hourwith the opportunity for advancement. As part of our commitment to pay equity, PPCCC does not negotiate salaries.Pay Differential: $0.50/hour bilingual Spanish/English differential pay is offered upon passing the language assessment test.
Job Specification