Billing Coordinator I

Planned Parenthood Mar Monte•San Jose, CA

6d•Hybrid

About The Position

The Billing Coordinator I is responsible for ensuring the accuracy and compliance of governmental and non-governmental payer claims. This role involves daily monitoring of unbilled charges, claim production reports, and rejected claims queues to identify and resolve discrepancies. The Billing Coordinator will also respond to billing-related inquiries, process incoming correspondence, and ensure timely claim submission while adhering to departmental policies and HIPAA regulations. For remote employees, maintaining a secure and HIPAA-compliant work environment is essential.

Requirements

High School Diploma required
Knowledge of professional claims billing or one to two years of experience in medical billing.
Ability to manage multiple tasks/projects simultaneously and adapt to frequent priority changes
Good writing, editing and communication skills with attention to detail and accuracy
Basic proficiency in Microsoft Word and Excel
Must adhere to all HIPPA guidelines and regulations and maintain patient and organization confidentiality.
Must follow affiliate policies and procedures

Nice To Haves

Knowledge of Medi-Cal, State Programs & Commercial Insurance (HMO, PPO, EPO, etc) preferred

Responsibilities

Review governmental and non-governmental payer claims for accuracy and ensure billing charges comply with payer-specific guidelines.
Work daily unbilled charge reports to identify discrepancies, process charges, and submit claims according to established processes and workaids.
Monitor and resolve claim production red edit reports daily, to clear edit, coordinate with health center staff for corrections and ensure timely claim submission.
Review and resolve rejected claims queues in the clearinghouse to transmit claims per workaids and expectation set by department.
Respond to billing-related inquiries from health center staff to expand knowledge of issues and resolutions methods.
Process incoming correspondence for the assigned health centers, including payer notifications, returned claims and take appropriate action to resolve and rebill to the corrected claim.
Meet department’s productivity and claim submission benchmarks and billing Key Performance Indicators (KPIs) and benchmarks.
Adhere to departmental policies, procedures, billing guidelines, productivity expectations, and established timelines.
Maintain confidentiality of patient and organizational information in accordance with HIPAA regulations.
For remote work arrangements, maintain a secure, organized, and HIPAA-compliant work environment that supports productivity and protects confidential information.
Perform other duties and special projects as assigned.
Serve as backup for other employees for breaks and absences as needed.