Remote Billing Coordinator I: Claims & Compliance

Planned Parenthood of the Pacific Southwest; San Jose (CA); Hybrid; USD 30,000 - 39,000; Full time

Job summary

Planned Parenthood of the Pacific Southwest is seeking a medical billing professional to review payer claims and ensure charges align with guidelines. The role involves processing unbilled charges, clearing claim edits, and submitting claims on time with accuracy.

You will assist in handling inquiries, manage payer notifications, and rebill according to corrections. This position may require onsite work near the administrative office and supports a HIPAA-compliant environment.

Qualifications

• High School Diploma required.

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 edits and coordinate corrections with health center staff for 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, returned claims and rebill to corrected claim.
• May report onsite when required and perform additional duties and special projects near the administrative office.
• Meet department productivity and claim submission KPIs and benchmarks and adhere to policies and timelines.
• Maintain confidentiality of patient and organizational information per HIPAA regulations.

Education

High School Diploma

Tools

Microsoft Word

Microsoft Excel

Job description

Planned Parenthood of the Pacific Southwest is seeking a medical billing professional to review payer claims and ensure charges align with guidelines. The role involves processing unbilled charges, clearing claim edits, and submitting claims on time with accuracy.

You will assist in handling inquiries, manage payer notifications, and rebill according to corrections. This position may require onsite work near the administrative office and supports a HIPAA-compliant environment.