Accounts Receivable Claims Specialist

Planned Parenthood of Orange and San Bernardino Counties has a full-time opportunity for an Accounts Receivable Claims Specialist in Anaheim, CA.

The Accounts Receivable Claims Specialist assures timely reimbursement of clean claims, corrects denied claims, and appeals denied or delayed claims with specific payors in order to receive reimbursement for healthcare claims.

Responsible for aging management and efficient claims collections and 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

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.

 

Minimum Education:


* High School Diploma or equivalent required.

 

Minimum Work Experience:


* 3-4 years of experience in billing and coding procedures required.


* 3-4 years of experience with insurance billing and reimbursement procedures required.


* A minimum of 3 - 4 years of experience as a medical biller/claims follow-up specialist or collections specialist in an outpatient medical setting (non-hospital) in primary care (required), family planning, ob-gyn, and related surgeries required.


* Knowledge of medical terminology and common industry abbreviations required.


* A minimum of 3 years of experience with HIPAA 5010 transaction standards required.


* A minimum of 3 years of claims follow-up/appeals and health plan Accounts Receivable management for specific payors required.

 Other Requirements:


* Ability to successfully communicate with payors, including insurance companies, health plans, and medical groups, regarding unpaid claims.


* Knowledge of Medi-Cal Managed Care, Commercial Payors, Medi-Cal, FPACT, & PE.


* Knowledge of health care and Medi-Cal denial reasons, denials codes and descriptions and standard denial resolution practices.


* Strong verbal and written communication skills are essential.


* Ability to demonstrate mature judgment, initiative, and critical thinking.


* Strong follow-up skills and time management with internal and customer stakeholders.


* Ability to ...