Claims Specialist

Job Title

Planned Parenthood California Central Coast (PPCCC) is an equal opportunity employer, we welcome all applicants regardless of their race, religious creed, color, national origin, ancestry, physical or mental disability, medical condition, genetic information, marital status, sex, gender identity, gender expression, age, sexual orientation, military or veteran status, and all other protected categories by applicable law.

PPCCC is a trusted provider of high-quality, affordable reproductive health care along California's Central Coast. Each year, PPCCC provides 28,000 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 Center Director or Clinician.
• Minimal 2 years billing experience in a clinic work environment.
• Knowledge of FamilyPACT, MediCal and commercial billing.

Qualifications

Thorough knowledge of third party insurance billing, including Medi-Cal, Medicare, and private insurance.

Solid understanding of CPT-4 and ICD-9/10 codes.

Strong work ethic, able to work independently, self-motivated.

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.

Must have a valid driver's license as this position requires travel to workshops and other Planned Parenthood sites including but not limited to PPCCC's geographic area.

Education and/or Experience

High School diploma or equivalent

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 $29.86/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.

Pay Differential: $1.00/hour bilingual Spanish/English differential pay is offered upon passing the language assessment test.