Planned Parenthood Mar Monte is one of the largest affilliates of Planned Parenthood nationwide. We are currently looking for experienced Medical Billing Specialist individiduals to fill 2 openings in our San Jose Billing Department. This is a temporary full time position, 2 months.
DESCRIPTION OF DUTIES
ESSENTIAL DUTIES
Level II: Complete one or more of the following duties, under minimal supervision:
DESCRIPTION OF DUTIES
ESSENTIAL DUTIES
Level II: Complete one or more of the following duties, under minimal supervision:
CDS data entry and balancing for assigned clinics on a daily basis in accordance with the month end closing.
Review and edit HCFA 1500 claim forms to be submitted to Medi-Cal managed care, Medicare or plans for accuracy, completeness and compliance with payor requirements. Submit to payor.
Prepare UB-92 forms for services and/or payors requiring that billing format.
Address billing questions from clinical staff regarding issues dealing with patient eligibility, data entry, coding and other payor requirements.
Review and edit PM160 CHDP claim forms to be submitted to CHDP, EDS and/or Medi-Cal managed care plans for accuracy, completeness and compliance with payor requirements. Submit to payer.
Work AR reports to identify slow payers and the need to do rebilling.
From RAs identify opportunities for rebilling of claims, research claims to determine cause of denial and verify that the claim should be paid. Printscreen claim and complete UB-92 or CIF as appropriate.
Generate reports and track the affiliate denials for errors and coding issues distribute to appropriate individuals for feedback to the clinics and management.
Contact insurance companies as necessary to resolve payment, denials and billing issues.
Bill for Blue Cross medications and supplies through the Wellpoint system.
NON-ESSENTIAL DUTIES
Assist in providing information and materials for annual audit of agencys financial records.
Perform verity of clerical tasks for the billing dept., including typing, filing, and sorting, posting or copying.
Serve as back up for other employees when needed to get CDSs (or money) entered before day/month end closes.
Support CFO in requests for payment and denial research.
Works with/supervises volunteers/interns as applicable.
Perform other duties as assigned.
QUALIFICATIONS
Ability to perform the duties as described above. A typical means of acquiring these abilities would be:
High School Diploma
1-3 years of related education and/or experience in Medical Billing.
REQUIREMENTS
Ability to operate with accuracy a 10-key calculator or computer keyboard by touch; ability to organize and maintain files and records; ability to work independently and to plan and organize work effectively; ability to communicate effectively, both verbally and in writing. In-depth knowledge of the different payor sources, billing requirements and timelines is required. Ability to enter data into Medic in both a timely and accurate manner.
1. JOB KNOWLEDGE: Must posses detailed knowledge of all aspects of assigned duties as well as of the computer applications necessary to carry out these duties.
1. EFFICIENCY: Must complete assigned duties in timely manner.
1. ACCURACY: Must carry out job duties with a high level of accuracy. When work is checked, errors should be infrequent.
1. WORKING RELATIONSHIPS: Must continuously demonstrate ability to work effectively, cooperatively, and harmoniously with co-workers and others encountered in the course of the job.
1. RELIABILITY AND DEPENDABILITY: Must be counted on to complete assigned duties. Must be punctual and maintain regular attendance with minimum number of unplanned absences.
1. INITIATIVE: Must demonstrate initiative in requesting additional work or helping others once regular duties have been completed. Must make useful suggestions on how workflow can be improved.
CDS data entry and balancing for assigned clinics on a daily basis in accordance with the month end closing.
Review and edit HCFA 1500 claim forms to be submitted to Medi-Cal managed care, Medicare or plans for accuracy, completeness and compliance with payor requirements. Submit to payor.
Prepare UB-92 forms for services and/or payors requiring that billing format.
Address billing questions from clinical staff regarding issues dealing with patient eligibility, data entry, coding and other payor requirements.
Review and edit PM160 CHDP claim forms to be submitted to CHDP, EDS and/or Medi-Cal managed care plans for accuracy, completeness and compliance with payor requirements. Submit to payer.
Work AR reports to identify slow payers and the need to do rebilling.
From RAs identify opportunities for rebilling of claims, research claims to determine cause of denial and verify that the claim should be paid. Printscreen claim and complete UB-92 or CIF as appropriate.
Generate reports and track the affiliate denials for errors and coding issues distribute to appropriate individuals for feedback to the clinics and management.
Contact insurance companies as necessary to resolve payment, denials and billing issues.
Bill for Blue Cross medications and supplies through the Wellpoint system.
NON-ESSENTIAL DUTIES
Assist in providing information and materials for annual audit of agencys financial records.
Perform verity of clerical tasks for the billing dept., including typing, filing, and sorting, posting or copying.
Serve as back up for other employees when needed to get CDSs (or money) entered before day/month end closes.
Support CFO in requests for payment and denial research.
Works with/supervises volunteers/interns as applicable.
Perform other duties as assigned.
QUALIFICATIONS
Ability to perform the duties as described above. A typical means of acquiring these abilities would be:
High School Diploma plus one to three years of related education and/or experience in Medical Billing.
REQUIREMENTS
Ability to operate with accuracy a 10-key calculator or computer keyboard by touch; ability to organize and maintain files and records; ability to work independently and to plan and organize work effectively; ability to communicate effectively, both verbally and in writing. In-depth knowledge of the different payor sources, billing requirements and timelines is required. Ability to enter data into Medic in both a timely and accurate manner.
1. JOB KNOWLEDGE: Must posses detailed knowledge of all aspects of assigned duties as well as of the computer applications necessary to carry out these duties.
1. EFFICIENCY: Must complete assigned duties in timely manner.
1. ACCURACY: Must carry out job duties with a high level of accuracy. When work is checked, errors should be infrequent.
1. WORKING RELATIONSHIPS: Must continuously demonstrate ability to work effectively, cooperatively, and harmoniously with co-workers and others encountered in the course of the job.
1. RELIABILITY AND DEPENDABILITY: Must be counted on to complete assigned duties. Must be punctual and maintain regular attendance with minimum number of unplanned absences.
1. INITIATIVE: Must demonstrate initiative in requesting additional work or helping others once regular duties have been completed. Must make useful suggestions on how workflow can be improved.
To APPLY, visit www.ppmarmonte.org
Job ID: Billing Specialist Level 2 - San Jose, Ca
- Compensation: DOE
- This is at a non-profit organization.
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- Please, no phone calls about this job!
- Please do not contact job poster about other services, products or commercial interests.