OHS Medical Biller

Planned Parenthood of Orange and San Bernardino Counties has a full-time opportunity for a OHS Medical Biller in Anaheim, CA.

Assures timely eligibility for appointments, working with OHS dashboard, billing and reimbursement of clean claims, corrects denied claims, appeals denied or delayed claims for OHS payers in order to receive reimbursement for healthcare claims.

Responsible for verifying eligibility for online health appointments, working directly with OHS dashboard, creating patient accounts with patient demographics in EHR system, creating claims and billing to OHS payers with claims follow up.

 

At PPOSBC, we understand the importance of a well-rounded benefits program and are dedicated to providing you with unique benefits that meet the needs of you and your family.

We are proud to offer a range of plans that help protect you in the case of illness or injury including:


* A competitive benefits package including medical, dental, and vision coverage for you and eligible dependents, life insurance, and long term disability. 


* Benefits coverage starts after one full month of employment!


* Generous vacation, sick, and holiday benefits!


* Generous 401(k) matching contributions and more!


* To view our detailed benefits guide, please visit our career site at www.pposbccareers.org

Responsibilities

Essential Functions: Essential functions encompass the required tasks, duties and responsibilities performed as part of the job and the reason the job exists.


* Knowledge of payer guidelines.


* Knowledge of industry standard and Medi-Cal denials reasons/codes.


* Knowledge of several different coding systems, including Level 1 HCPCS and Level 2 HCPCS.


* Understand and verify eligibility.


* Setup patient accounts in practice management system.


* Submit claims daily to insurances.


* Ensure all Online Health Services appointments are billed.


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* Follow up on claim submissions to determine batch acceptance, rejection, or denial.


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* Communicates with RCM leadership about payer updates, changes, and requirements.


* Investigates insurance fraud and reports if found.


* Maintains strict confidentiality.


* Other duties as assigned by Manager of Revenue Cycle Management. 

Non-Essential Functions:


* Other duties as assigned. 

PHYSICAL REQUIREMENTS:

The physical requirements of this position are identified below.

Reasonable accommodations may be made for individuals with disabilities to perform the essential functions of this position.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.

The requirements listed below are representative of the knowledge, skill, and/or ability required.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

Licensure and/or Certification Requirements:


* Billing certificate preferr...