Senior Billing Specialist
About The Position
At Planned Parenthood of Greater New York (PPGNY), our greatest strengths are the employees who empower every individual with the information, resources, and care they need to live happy, healthy lives. Picture yourself here: We are a team of trusted health care providers, educators, and fierce advocates committed to advancing equity and improving health outcomes in communities that face systemic barriers to quality, innovative sexual and reproductive health services -- including birth control, pregnancy testing, emergency contraception, cancer screenings, STI testing and treatment, HIV testing and prevention, transgender hormone therapy, wellness exams, crisis counseling, and financial counseling. PPGNY also proudly provides compassionate, nonjudgmental abortion services. When you join PPGNY as a Sr. Billing Specialist you will be responsible for the review, analysis and maintenance of patient account balances for Medicaid commercial payers and other payer types. Individuals must have prior experience with NYS Medicaid. The position will perform various audits utilizing Excel and EPIC reports to identify accurate reimbursement based on various payer contracts. Responsible for working in various EPIC work queues, (WQ) to identify charge/pricing errors and recommendation for automation to the Manager Billing. Individuals needs to be able to work with large data and perform analytical analysis . Picture yourself here: We are a team of trusted health care providers, educators, and fierce advocates committed to advancing equity and improving health outcomes in communities that face systemic barriers to quality, innovative sexual and reproductive health services -- including birth control, pregnancy testing, emergency contraception, cancer screenings, STI testing and treatment, HIV testing and prevention, transgender hormone therapy, wellness exams, crisis counseling, and financial counseling. PPGNY also proudly provides compassionate, nonjudgmental abortion services.
Requirements
- High School diploma or GED.
- Five plus years in healthcare billing experience.
- Three plus years EPIC knowledge and utilization.
- Intermediate to advanced Microsoft suite utilization.
- Strong NYS CMS Compliance knowledge and auditing guidelines.
- A demonstrated commitment to PPGNY’s mission related to bodily autonomy, health equity, gender and racial justice.
- A demonstrated commitment to learning about and enhancing practices related to racial equity and its impact on healthcare systems.
- Strong relationship building and communication skills, including an ability to work and build trust across cultural differences related to race, age, gender, gender identity and expression, sexual orientation, religion, ethnicity, national origin or ability; and to reflect on one’s personal identity with humility.
- Proof of immunization or immunity to certain communicable diseases (including influenza during the flu season and Covid-19) and testing for tuberculosis. These certifications are required by the NYC DOHMH Health Code, NYSDOH and OSHA.
Nice To Haves
- Associate’s degree in business
- Advanced Excel spreadsheet development
Responsibilities
- Responsible for working various WQ’s to resolution.
- Identify EPIC WQ’s issues, develop and implement work plans to remediate issues with Manager, Billing.
- Identify charge/pricing issues to ensure optimal charging of services with Manager billing.
- Identify provider opportunities for improvement in charging and missing documentation.
- Responsible for oversight of Grants and Funding invoicing and reconciliation.
- Maintain NYS Medicaid rules and regulations updates and disseminate information accordingly.
- Responsible for various audits to ensure compliant billing and charging utilizing EPIC reports; workbench, slicer dicer and Excel pivots, v look up and efficient presentations.
- Develops and implements reporting tools to identify revenue cycle trends, including root cause of denials.
- Perform under and over payment analysis.
- Performs ad hoc data analysis to address operational issues identified.
- Through audits and WQ management identify registration training needs for all registration areas working with RCM leadership and Regional Directors of Operations and CHN patient Access.
- Development of education and training materials regarding payor updates.
- Complete mandatory training and attendance of various meetings.
Benefits
- Generous PTO and holiday schedule
- Medical, dental and vision coverage options for you and eligible dependents
- FSA, HSA, Commuter pre-tax reimbursement funds
- Short- and Long-Term Disability, Free Basic Life and AD&D
- 401(k) Retirement Plan with Safe Harbor contributions after 1 year of employment
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
High school or GED
