Coding Specialist Biller 2 (WA)_Revenue Cycle Operations

ppgnhi.org; Seattle (WA); On-site; USD 37,000 - 54,000; Full time

Benefits offered by this job

Medical, dental & vision

Retirement plan with match

Life insurance

Short/long-term disability

Transportation benefits

Job summary

Planned Parenthood of the Great Northwest & the Hawaiian Islands is seeking a Coding Specialist/Biller 2 in Seattle, WA to ensure compliant medical documentation, coding and billing under supervision. The role focuses on front-end revenue cycle improvements and accurate claim processing.

The position requires CPC certification, an associate degree in finance or related field, at least two years in medical billing, and experience with CPT-4/ICD-10, Epic or similar EHR systems.

Qualifications

• Associate degree in finance, accounting, or related field.
• Certified Professional Coder (CPC) certification required.
• Minimum of two years of medical billing experience.
• Experience with electronic practice management and health record systems (Epic a plus).
• Comprehensive, in-depth experience with the front-end revenue cycle.

Responsibilities

• Perform prospective and retrospective coding reviews to ensure claims are accurate, and make needed corrections for payer reconsideration.
• Submit and manage provider coding queries for cases that need additional documentation or a provider response.
• Review all rejections and denials, including coding and documentation issues, and take action to resolve claims.
• Accurately bill third-party payers to maximize reimbursement, following all department procedures and processes.
• Provide medical records for billing-related requests, including claim reimbursement, payer audit, and risk adjustment requests.

Job description

Coding Specialist/Biller 2Working at Planned Parenthood of the Great Northwest & the Hawaiian Islands, Indiana, & Kentucky is more than a job. It provides the opportunity to contribute to our powerful mission and perform meaningful work. In healthcare services, this means a commitment to providing the absolute best in patient care and education. Our exceptional health center staff drives our mission forward by upholding our acclaimed customer service & confidentiality standards, and working to create a safe, judgement-free space for anyone seeking Planned Parenthood services. As an organization, we are focused on equity, diversity and inclusion. Specifically, we recognize that profound racism impacts the education, health and wellbeing of people in our communities and we are actively working to address all forms of oppression. We believe our employees should reflect the diversity of the populations we serve, including racial and ethnic diversity. People of color are strongly urged to apply.

About this position:

Under the supervision and direction of the Director, Manager, or Supervisor, the Coding Specialist/Biller 2 ensures compliance in medical documentation, coding, and billing. This role performs the duties of the Biller 2, with time set aside for coding and documentation activities.

What you'll be doing:

You will ensure that coding and billing comply with applicable rules and regulations. You will work with staff to improve the front-end revenue cycle procedures carried out in our Health Centers, and you will support coding and revenue cycle activities.

Key Responsibilities:

• Perform prospective and retrospective coding reviews to ensure claims are accurate, and make needed corrections for payer reconsideration
• Submit and manage provider coding queries for cases that need additional documentation or a provider response
• Work assigned work queues to verify claim accuracy, take corrective action, and ensure timely filing
• Write off balances when appropriate, up to the approval level authorized for a Coding Specialist/Biller
• Review all rejections and denials, including coding and documentation issues, and take action to resolve claims
• Identify trends in rejections and denials and report findings to the Coding Integrity Manager for follow-up
• Ensure quality, compliance, and continuous improvement in coding, documentation, and billing
• Accurately bill third-party payers to maximize reimbursement, following all department procedures and processes
• Check proof of eligibility according to organizational and third-party protocols
• Respond to inquiries from patients, health center staff, and insurance companies in line with affiliate customer service standards
• Provide pre-verification services to health centers and patients as requested
• Monitor help desk tickets, refer patient callback tickets to a Patient Account Representative when appropriate, and work other tickets to prompt resolution
• Ensure bills are processed on time by managing work queues and correcting electronic bill submissions
• Follow up on all incorrect, denied, and unpaid claims, and reconcile third-party accounting information
• Support internal and external coding audits
• Provide medical records for billing-related requests, including claim reimbursement, payer audit, and risk adjustment requests

Education:

Associate degree in finance, accounting, or a related field preferred

Certifications:

Certified Professional Coder (CPC) certification required

Experience:

Minimum of two years of experience in a medical billing operation required

Demonstrated experience with electronic practice management and health record systems (Epic a plus)

Experience with health center management highly desirable

Comprehensive, in-depth experience with the front-end revenue cycle

Skills:

Thorough understanding of third-party payer contracts, Medicaid reimbursement, and compliance

Proficiency and advanced working knowledge of CPT-4 and ICD-10 coding requirements

Advanced knowledge of third-party billing and OIG billing compliance guidelines

Ability to maintain confidentiality of all PPGNHAIK business and activities, on and off the job

Salary Range:

WA: $26.65 – $38.93 per hour

Location:

2001 East Madison Street; Seattle, WA 98122

Position Type:

Full-time – Non-exempt

Benefits Eligibility:

This position is eligible for PPGNHAIK benefits. As part of our total compensation, we provide a comprehensive benefits plan including medical, dental and vision plans, retirement, paid time off, short and long-term disability, and life insurance. For more information about our benefits program, please email [e-mail].

Other Information:

All our employees must present proof of receiving a current flu shot prior to their first day of employment.

What we expect from you:

• That you adhere to our code of conduct, policies, procedures, and protocols.
• That you always demonstrate a high degree of professionalism.
• That you always support and model our customer service standards.
• That you value continuous learning and seek ongoing training and development.

Perks

As part of our total rewards package, we offer meaningful work, generous time off and benefits, promotional opportunities, and competitive compensation. Our attractive benefits package includes medical, dental and vision coverage for you and eligible dependents, life insurance, short and long term disability coverage, as well as a retirement plan with matching contributions by employer. We also provide transportation benefits at eligible locations. For additional information regarding compensation, pay scales, or total rewards, please reach out to [e-mail].

Equal opportunity employment

PPGNHI is an equal-opportunity employer and seeks to recruit persons of diverse backgrounds - and to support their retention and advancement within the organization. We are committed to fostering a workplace culture inclusive of people with respect to their race, ethnicity, national origin, gender/gender identity, sexual orientation, socio-economic status, veteran status, marital status, age, disabilities, political affiliation, religious beliefs or any other characteristic.