The vision of Clinical Health Network for Transformation (CHN) is to better fulfill the mission and promise of Planned Parenthood to bring high-quality, affordable care to every member of our communities. CHN is a collaboration between Planned Parenthood affiliates across the United States. CHN is looking for individuals who are committed to supporting our shared goal of strengthening and enhancing our awareness and commitment to advancing the cause of health and race equity in our organization.
Reporting directly to the Revenue Cycle Manager, the Revenue Cycle Representative is responsible for activities leading up to the initial electronic claims submission to include charge entry edits, payment posting, and overall account resolution of patient accounts by interacting with patients and insurance payors. This position ensures timely submission of electronic claims, daily resolution of clearinghouse rejections and will assist in monitoring and resolving outstanding balances including unpaid, partial paid, underpaid, and overpaid claims for insurance and patient balances using aging reports, work queues and goal settings.
\n Essential FunctionsResolving pre-bill claim edits and ensure claims are clean and submitted dailyReviewing daily clearinghouse rejections, resolving, and resubmitting accountsPosting all insurance and patient payments received through automated and manual channelsReview aged accounts and take steps to resolve for payment by contacting payors for claim status, process rebilling requests and escalating issues when neededReviews denied claims to resolve by resubmitting corrected claims or filing claim reconsiderations Reconciling all insurance and patient credit balances/overpayments and ensuring a timely refund is processedFirst to receive and address all channels of patient billing inquiries and escalate as appropriateCollect patient co-pays/coinsurance/deductible amounts due after insuranceEstablish, monitor, and pursue patients with payment plans until reconciliationMail and correspondence management along with other department administrative functionsPerform various clerical activities to support daily operationsCreates and promotes a culture of continuous improvementEnsures compliance with all CHN and affiliate policies, as well as all state and federal regulationsDemonstrates a commitment to CHN and Planned Parenthood's mission related to health equity, especially centering racial equity, and deep sense of accountability to communityDemonstrates a commitment to learning about and enhancing practices related to racial equity and the impact of structural racism on healthcare systemsProvides positive and development feedback and accountability related to practices including, but not limited to, equityThe above duties and responsibilities are not an exhaustive list of required responsibilities, duties, and skills. Other duties may be added, and this job description can be amended at anytime. Qualifications and Experience (Required)1 to 2 years of relevant account receivable experience Previous experience using ICD-10 Medical Coding and Current Procedural Terminology (CPT)Knowledge of medical terminologyStrong analytical and problem-solving abilitiesProficiency with Microsoft software (Excel, etc.)Demonstrated ability to maintain a customer-centric service approach in a fast-paced environmentExcellent written and verbal communication skills and ability to collaborate and interact with all levels within and outside of CHN if necessaryStrong attention to detail and follow-up; and ability to multi-task in fast-paced environmentDemonstrated dedication to Planned Parenthood's mission, vision, and valuesStrong interpersonal skills and the ability to build relationships with stakeholdersExcellent time management, and problem-solving skills Qualifications and Experience (Preferred)Strong General Technology Skills: proficient utilization of Excel, Word, and Windows environment, Epic, eCW, NextGen or other practice management systems experience a plus Medical Billing and Coding certification, a plus Key RequirementsCommitment to advancing race (+) equity in one's work: interested in expanding knowledge about the role that racial inequity plays in our societyAwareness of multiple group identities and their dynamics, bringing a high level of self-awareness about personal identity, empathy, and humility to interpersonal interactionsDemonstrated ability to communicate clearly and directly as well as hear and act on feedback related to identity and equity with the aim to learnStrong sense of accountability to equitable practicesUnderstanding of the impact of identity dynamics on organizational cultureCommitment to CHN and Planned Parenthood's In This Together service ethos, workplace values, and service standards
\n$18.07 - $27.11 an hour
CHN believes in fair and equitable pay. Above is the pay range for this role. Please note that actual salaries may vary within the range, based on factors including, but not limited to, education, training, experience, professional achievement, and business need.
CHN provides employees with a competitive benefits package; some highlights include the following.
- Health Care Coverage (Medical, Dental, & Vision); eligibility for full-time, regular employees on date of hire
- Flexible Spending Accounts and Health Savings Account
- Short-Term Disability and Basic Life & AD&D Insurance provided by CHN
- Voluntary elections for Long Term Disability and Additional Life & AD&D Insurance available at cost
- Employee Assistance Program
- Retirement Plan, 3% employer match after one year of service
- Paid Time Off Program includes accrual-based PTO, Health Time Off (HTO), and nine (9) paid Holidays
\nClinical Health Network for Transformation (CHN) is an equal employment opportunity employer. We comply with all applicable laws prohibiting discrimination based on race, color, religion, gender and gender expression/identity, age, ethnicity, national origin, ancestry, physical or mental disability, uniformed service member/veteran status, marital status, medical condition, pregnancy, sexual orientation, citizenship status, genetic information, as well as any other category protected by federal, state, or local. We are committed to building an inclusive workplace that values racial & social justice. We strongly encourage all persons to apply, including people of color and members of the LGBTQ community.