PPPSW Compensation Philosophy and Position Hiring Rate:

• At Planned Parenthood of the Pacific Southwest (PPPSW) the philosophy behind our compensation efforts is to foster workplace equity by aligning pay and benefit structures with our Agency’s mission and values. These efforts are continuously evaluated as we work toward living out our social justice values as an employer. PPPSW recognizes that decisions about pay and benefits have significant impact on staff, and we work diligently to ensure all positions are compensated competitively as compared to other similar positions in the community. The Affiliate establishes compensation supported by a position description that identifies competencies, duties, responsibilities and qualifications. In alignment with the Agency culture, PPPSW will strive to communicate openly and transparently about the goals of the Agency and the design of the compensation policies. The Agency will ensure the compensation program is administered in a manner that is consistent with Agency’s value of pay equity.

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  The hiring rate for this position is: $20.00-$23.89/hour

In this role, you'll get to:

• Prepare and submit clean claims to third party payers, either electronically or on paper; work claim rejections.

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  Verify Insurance eligibility, benefits and patient cost shares.

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  Perform post-visit financial counselling with patients to ensure they are aware of their insurance coverage and financial responsibility. Explain complex insurance topics such as benefit coverages, copays, deductibles and coinsurance.

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  Negotiate payment plans for patients who cannot afford to pay cost of services in full.

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  Serve as a patient advocate ensuring they are aware of and take advantage of programs such as Medi-Cal, Family Pact and available sliding fee discounts.

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  Analyze and process third party payments/adjustments.

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  Determine the appropriateness of appealing denied claims, and take necessary actions to resubmit those claims on a timely basis.

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  Work aging and rebill reports; perform effective follow-up on unpaid claims using EPM tasking.

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  Update EPM system with notes from conversations with patients, payers, Contact Center or Health Center Staff. Ensure new or pertinent demographic information from patients is updated to ensure clean claim submission to 3rd party payers.

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  Answer questions from patients, internal customers and insurance companies.
  

• Provide counseling to patients and Health Center staff on complicated insurance questions.

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  Prepare, review, and send patient statements.

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  Identify and resolve patient billing complaints.

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  Perform various collection efforts including contacting patients by phone.

What we're looking for:

• 2-4 years of recent third-party billing/coding experience or equivalent required.

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  2-4 years of recent practice management system and collections experience required

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  (Recent experience defined as experience within at least the last 6 months)

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  Knowledge of PPO, HMO, IPA, MSO, and Medi-Cal billing practices & protocols

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  Knowledge of CPT & ICD codes