Senior Billing Specialist
Planned Parenthood of Greater New York, Brooklyn, New York, United States, 11201
Sr. Billing Specialist
At Planned Parenthood of Greater New York (PPGNY), our greatest strengths are the employees who empower every individual with the information, resources, and care they need to live happy, healthy lives. Picture yourself here: We are a team of trusted health care providers, educators, and fierce advocates committed to advancing equity and improving health outcomes in communities that face systemic barriers to quality, innovative sexual and reproductive health services -- including birth control, pregnancy testing, emergency contraception, cancer screenings, STI testing and treatment, HIV testing and prevention, transgender hormone therapy, wellness exams, crisis counseling, and financial counseling. PPGNY also proudly provides compassionate, nonjudgmental abortion services. When you join PPGNY as a Sr. Billing Specialist you will be responsible for the review, analysis and maintenance of patient account balances for Medicaid commercial payers and other payer types. Individuals must have prior experience with NYS Medicaid. The position will perform various audits utilizing Excel and EPIC reports to identify accurate reimbursement based on various payer contracts. Responsible for working in various EPIC work queues, (WQ) to identify charge/pricing errors and recommendation for automation to the Manager Billing. Individuals needs to be able to work with large data and perform analytical analysis. Duties and Responsibilities Revenue Cycle Billing (75%) Responsible for working various WQ's to resolution. Identify EPIC WQ's issues, develop and implement work plans to remediate issues with Manager, Billing. Identify charge/pricing issues to ensure optimal charging of services with Manager billing. Identify provider opportunities for improvement in charging and missing documentation. Responsible for oversight of Grants and Funding invoicing and reconciliation. Maintain NYS Medicaid rules and regulations updates and disseminate information accordingly. Reporting, Monitoring and Compliance (15%) Responsible for various audits to ensure compliant billing and charging utilizing EPIC reports; workbench, slicer dicer and Excel pivots, v look up and efficient presentations. Develops and implements reporting tools to identify revenue cycle trends, including root cause of denials. Perform under and over payment analysis. Performs ad hoc data analysis to address operational issues identified. Training and Education: (10%) Through audits and WQ management identify registration training needs for all registration areas working with RCM leadership and Regional Directors of Operations and CHN patient Access. Development of education and training materials regarding payor updates. Complete mandatory training and attendance of various meetings. Core Competencies A demonstrated commitment to PPGNY's mission related to bodily autonomy, health equity, gender and racial justice. A demonstrated commitment to learning about and enhancing practices related to racial equity and its impact on healthcare systems. Strong relationship building and communication skills, including an ability to work and build trust across cultural differences related to race, age, gender, gender identity and expression, sexual orientation, religion, ethnicity, national origin or ability; and to reflect on one's personal identity with humility. Required Qualifications Minimum Education and Work Experience: High School diploma or GED. Five plus years in healthcare billing experience. Three plus years EPIC knowledge and utilization. Intermediate to advanced Microsoft suite utilization. Strong NYS CMS Compliance knowledge and auditing guidelines. Preferred Qualifications Associate's degree in business Advanced Excel spreadsheet development Typical Physical Demands Requires prolonged sitting and repetitive tasks including use of a computer. Periodic standing, walking, bending. Requires lifting or moving of up to 15 pounds. Visual acuity sufficient to perform frequent work on a computer screen and review printed reports and other materials. Requires the ability to hear and to communicate orally with others. This role routinely uses standard office equipment such as computers, phones, photocopiers, and filing cabinets, and will require reaching, grasping, pushing, and pulling. Typical Working Conditions This job operates in a professional office environment. Potential exposure to communicable diseases and other conditions in a health center environment. Requires flexible schedule and during peak activity periods work more than 7.5 hours per day. and/or 37.5 hours per week. $73,000 - $91,000 a year PPGNY's benefits package includes: Generous PTO and holiday schedule Medical, dental and vision coverage options for you and eligible dependents FSA, HSA, Commuter pre-tax reimbursement funds Short- and Long-Term Disability, Free Basic Life and AD&D 401(k) Retirement Plan with Safe Harbor contributions after 1 year of employment All positions at PPGNY require: Proof of immunization or immunity to certain communicable diseases (including influenza during the flu season and Covid-19) and testing for tuberculosis. These certifications are required by the NYC DOHMH Health Code, NYSDOH and OSHA. Planned Parenthood of Greater New York (PPGNY) is a leading provider, educator, and advocate of sexual and reproductive health care in New York State. PPGNY is proud to provide a wide-range of family planning services at our brick-and-mortar health centers and mobile care units. We care for everyone regardless of their immigration status, zip code or ability to pay. PPGNY's education and outreach programs are backed by medically accurate, evidence-based information that allows people to make informed decisions about their health and future. As a voice for reproductive freedom, PPGNY supports legislation and policies that ensure all New Yorkers have access to the full range of reproductive health care and education. At PPGNY, we provide the absolute best care to our patients and our communities through innovative health care delivery and education programming. We care for everyone who walks through our doors regardless of insurance, ability to pay or immigration status. As a leading voice for reproductive freedom, PPGNY fiercely advocates for policies to ensure that all New Yorkers will have access to the full range of reproductive health care services and information. PPGNY is committed to diversity, equity, and inclusion. We believe we are most impactful when people with a wide range of backgrounds, experiences, and identities come together with common purpose. We encourage candidates from all backgrounds to apply.
At Planned Parenthood of Greater New York (PPGNY), our greatest strengths are the employees who empower every individual with the information, resources, and care they need to live happy, healthy lives. Picture yourself here: We are a team of trusted health care providers, educators, and fierce advocates committed to advancing equity and improving health outcomes in communities that face systemic barriers to quality, innovative sexual and reproductive health services -- including birth control, pregnancy testing, emergency contraception, cancer screenings, STI testing and treatment, HIV testing and prevention, transgender hormone therapy, wellness exams, crisis counseling, and financial counseling. PPGNY also proudly provides compassionate, nonjudgmental abortion services. When you join PPGNY as a Sr. Billing Specialist you will be responsible for the review, analysis and maintenance of patient account balances for Medicaid commercial payers and other payer types. Individuals must have prior experience with NYS Medicaid. The position will perform various audits utilizing Excel and EPIC reports to identify accurate reimbursement based on various payer contracts. Responsible for working in various EPIC work queues, (WQ) to identify charge/pricing errors and recommendation for automation to the Manager Billing. Individuals needs to be able to work with large data and perform analytical analysis. Duties and Responsibilities Revenue Cycle Billing (75%) Responsible for working various WQ's to resolution. Identify EPIC WQ's issues, develop and implement work plans to remediate issues with Manager, Billing. Identify charge/pricing issues to ensure optimal charging of services with Manager billing. Identify provider opportunities for improvement in charging and missing documentation. Responsible for oversight of Grants and Funding invoicing and reconciliation. Maintain NYS Medicaid rules and regulations updates and disseminate information accordingly. Reporting, Monitoring and Compliance (15%) Responsible for various audits to ensure compliant billing and charging utilizing EPIC reports; workbench, slicer dicer and Excel pivots, v look up and efficient presentations. Develops and implements reporting tools to identify revenue cycle trends, including root cause of denials. Perform under and over payment analysis. Performs ad hoc data analysis to address operational issues identified. Training and Education: (10%) Through audits and WQ management identify registration training needs for all registration areas working with RCM leadership and Regional Directors of Operations and CHN patient Access. Development of education and training materials regarding payor updates. Complete mandatory training and attendance of various meetings. Core Competencies A demonstrated commitment to PPGNY's mission related to bodily autonomy, health equity, gender and racial justice. A demonstrated commitment to learning about and enhancing practices related to racial equity and its impact on healthcare systems. Strong relationship building and communication skills, including an ability to work and build trust across cultural differences related to race, age, gender, gender identity and expression, sexual orientation, religion, ethnicity, national origin or ability; and to reflect on one's personal identity with humility. Required Qualifications Minimum Education and Work Experience: High School diploma or GED. Five plus years in healthcare billing experience. Three plus years EPIC knowledge and utilization. Intermediate to advanced Microsoft suite utilization. Strong NYS CMS Compliance knowledge and auditing guidelines. Preferred Qualifications Associate's degree in business Advanced Excel spreadsheet development Typical Physical Demands Requires prolonged sitting and repetitive tasks including use of a computer. Periodic standing, walking, bending. Requires lifting or moving of up to 15 pounds. Visual acuity sufficient to perform frequent work on a computer screen and review printed reports and other materials. Requires the ability to hear and to communicate orally with others. This role routinely uses standard office equipment such as computers, phones, photocopiers, and filing cabinets, and will require reaching, grasping, pushing, and pulling. Typical Working Conditions This job operates in a professional office environment. Potential exposure to communicable diseases and other conditions in a health center environment. Requires flexible schedule and during peak activity periods work more than 7.5 hours per day. and/or 37.5 hours per week. $73,000 - $91,000 a year PPGNY's benefits package includes: Generous PTO and holiday schedule Medical, dental and vision coverage options for you and eligible dependents FSA, HSA, Commuter pre-tax reimbursement funds Short- and Long-Term Disability, Free Basic Life and AD&D 401(k) Retirement Plan with Safe Harbor contributions after 1 year of employment All positions at PPGNY require: Proof of immunization or immunity to certain communicable diseases (including influenza during the flu season and Covid-19) and testing for tuberculosis. These certifications are required by the NYC DOHMH Health Code, NYSDOH and OSHA. Planned Parenthood of Greater New York (PPGNY) is a leading provider, educator, and advocate of sexual and reproductive health care in New York State. PPGNY is proud to provide a wide-range of family planning services at our brick-and-mortar health centers and mobile care units. We care for everyone regardless of their immigration status, zip code or ability to pay. PPGNY's education and outreach programs are backed by medically accurate, evidence-based information that allows people to make informed decisions about their health and future. As a voice for reproductive freedom, PPGNY supports legislation and policies that ensure all New Yorkers have access to the full range of reproductive health care and education. At PPGNY, we provide the absolute best care to our patients and our communities through innovative health care delivery and education programming. We care for everyone who walks through our doors regardless of insurance, ability to pay or immigration status. As a leading voice for reproductive freedom, PPGNY fiercely advocates for policies to ensure that all New Yorkers will have access to the full range of reproductive health care services and information. PPGNY is committed to diversity, equity, and inclusion. We believe we are most impactful when people with a wide range of backgrounds, experiences, and identities come together with common purpose. We encourage candidates from all backgrounds to apply.