Billing Coordinator I

Planned Parenthood Mar Monte; North Las Vegas (NV); Hybrid; USD 28,000 - 36,000; Full time

Job summary

Planned Parenthood Mar Monte in North Las Vegas, NV is seeking a Billing Specialist to review governmental and non-governmental payer claims for accuracy and ensure billing charges comply with payer guidelines. This full-time hybrid role requires processing daily unbilled charge reports and submitting claims according to established processes.

You will monitor claim production red edit reports, resolve rejected claims in the clearinghouse, respond to billing inquiries from health center staff,

Qualifications

• High School Diploma required.
• Knowledge of professional claims billing or 1–2 years of medical billing experience.
• Ability to manage multiple tasks/projects and adapt to priority changes.
• Good writing, editing and communication skills with attention to detail and accuracy.
• Knowledge of Medi-Cal, State Programs & Commercial Insurance preferred.
• Basic proficiency in Microsoft Word and Excel.
• Must adhere to HIPAA guidelines and maintain confidentiality.
• Must follow affiliate policies and procedures.

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, coordinating with health center staff for corrections and timely submission.
• Review and resolve rejected claims queues in the clearinghouse to transmit claims per workaids and department expectations.
• 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 and returned claims and rebill to corrected claims.
• May report onsite when required and perform additional duties and special projects near the administrative office.
• Meet department productivity and claim submission benchmarks and billing KPIs and timelines.
• Adhere to departmental policies and privacy guidelines.
• Maintain HIPAA-compliant environment for remote work arrangements.
• Perform other duties and special projects as assigned.
• Serve as backup for breaks and absences as needed.
• Perform other duties as assigned

Skills

Medical billing

Attention to detail

Communication skills

Multitasking

Education

High School Diploma

Tools

Microsoft Word

Excel

Job description

• 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.
• As assigned, 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.
• May need to report onsite when required and perform additional duties and special projects, if closer to the administrative office.
• Must 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
• Perform other duties as assigned

Full-Time (Hybrid)

Hiring at: $23/hr

Essential Duties

• 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.
• As assigned, 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.
• May need to report onsite when required and perform additional duties and special projects, if closer to the administrative office.
• Must 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

Non- Essential Duties

• Serve as backup for other employees for breaks and absences as needed
• Perform other duties as assigned

Qualifications

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