$ads={1}
A Claims Representative collects and verifies data about clients with the goal of improving client services. Job duties include handling Health Center phone calls, dropping charges and confirming accurate insurance information and payer requirements into the Nextgen billing software confirming appropriate CPT and ICD-10 codes are coded correctly and accurately appearing on claim submissions.
Planned Parenthood Pasadena & San Gabriel Valley (PPPSGV) has been proudly serving our community since 1933 and is one of the original Planned Parenthood affiliates in the nation.
We provide reproductive health care, health education and advocacy from our five health centers in
Alhambra, Baldwin Park, Glendora, Highland Park, and Pasadena, in addition to our telehealth clinic. We strive to ensure
the sexual and reproductive health services we provide align with the needs of the communities we serve. Our service area extends from Glendora to Glendale and from
the San Gabriel mountains to the San Bernardino freeway, home to 24 communities and a diverse population of 1.4 million people.
Today, PPPSGV sees over 60,000 patient visits per year and delivers over 15,000 opportunities for sex and relationship education in our schools and colleges.
We offer safe and legal abortions. We are committed to providing accurate, non-judgmental care and resources by helping our patients overcome financial, transportation, and other barriers to care. In addition, we work with abortion funds and practical support network to support our patients. Our abortion care has increased every year since 2018 with an average of 3,500 abortions per year. We saw close to 4,000 abortion patients in 2022 alone, approximately 59 were out-of-state patients.
In this position, you will change lives while you:
- Assist in preparing and entering third party billings for charges generated during Health Center business hours Monday – Saturdays
- Audit Super bills against charges in the EHR
- Print, prep, review and mail out all paper HCFA 1500 or UB04 claim, including attachments as necessary
- Communicate with Billing Manager and Health Center Teams for charge corrections and other areas of concerns via spreadsheet and/or tasks
- Problem solving skills to ensure accuracy of charges and claims
- Assist in special projects regarding re-submissions of claims
- Stay abreast of regulatory changes to billing and coding procedures and update practices accordingly
- Meet productivity standards set forth by Management team
- Maintain patient confidence and protect Admin office operations by meeting HIPAA requirements and maintaining PHI confidentiality
- Perform other duties as necessary
- Answer telephone calls as needed
- Assist with the planning and organization of departmental activities as needed and participate in said activities
- Participate in departmental meetings as necessary
We are looking for someone with the following:
- Education:
- High School Diploma or Equivalent
- Medical Billing Certification and/or 1-year equivalent experience
Experience:- Minimum of one year of experience, including third party billing, including understanding of CPT/HCPC and ICD-10 codes
- Understanding of processing and billing claims for Medi-cal/FPACT, Medi-cal Managed and Commercial Claims.
- Understanding of Billing Software, NextGen preferred
- Excellent Computer skills with strong emphasis of Microsoft word, excel, outlook and internet
Other:- Knowledge of State, PPO, HMO payers billing practices and protocols
- Must have willingness and ability to adapt to change including advances in technology
- Ability to multi-task and detail orientation
- Excellent internal customer service skills and be committed to providing the highest level of health center customer satisfaction
- Commitment to creating and supporting a diverse, equitable and inclusive workplace
- Supportive of the mission and goals of Planned Parenthood
$22 - $24 an hour
The hiring rate for this position is: $22- $24/hour + Medical, Dental, Vision, 401k Matching Program, Premium CALM account, holidays, paid time off, and more!
PPPSGV is committed to fostering an inclusive and diverse workplace. We offer a series of workshops during employee onboarding and throughout the year. We also provide additional opportunities to get involved in our diversity, equity, and inclusion (DEI) work through various task forces, conferences, and staff retreats.
We are a prominent team of passionate health experts who adhere to the highest standards as we collaborate and care for people without judgment. As we stand in solidarity with communities of color, we demand greater diversity, equity and inclusion (DEI) within our organization.
Join our team and be part of a powerful movement to shape the future of sexual and reproductive health!
Planned Parenthood Pasadena & San Gabriel Valley is an Equal Opportunity Employer.
Please visit our careers page for more information: Careers at PPPSGV | Planned Parenthood Pasadena & San Gabriel Valley
$ads={2}
