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Billing Specialist Prior Authorization

Company

Planned Parenthood of the Rocky Mountains, Inc.
Address , Albuquerque, Nm
Employment type FULL_TIME
Salary $20.19 - $22.15 an hour
Expires 2023-07-26
Posted at 1 year ago
Job Description
Position Salary Range $ 20.19- $ 24.11
Starting Pay Although our full pay range is included above, the budgeted hiring range for this position is $ 20.19- $ 22.15 per hour.
Non-Exempt

The Objective: Ensure PPRM is paid for all the healthcare services rendered and ensures that our patients have accurate financial information regarding their coverage and benefits.

Success:
You are successful when PPRM’s patients are able to access care and medication without delay because all administrative tasks related to prior authorization and referral requirements been appropriately resolved prior to a patient’s visit and PPRM is paid for all healthcare services rendered.
Snapshot:
You will work regular business hours supporting health centers and patients in a remote work capacity. You will need to be in front of a computer and available for 7.5 hours per day, answering questions, attending meetings, solving problems, and calling patients, payers, and pharmacy and relating information.
Qualifications:
Strong attention to detail, highly organized, process oriented, and ability to follow directions with precision. Task and solution oriented with well-developed sense of urgency, ability to take initiative, work independently, and problem solve. Strong written and verbal communication skills. Strong relationship building and interpersonal skills. Ability to successfully coordinate multiple projects simultaneously. Excellent time management skills with proven ability to meet deadlines and work under pressure. Must be able to maintain high standards of confidentiality and practice ethical communication. Able to gather and analyze data and organize into reports. Ability to handle multiple interruptions throughout the day and reprioritize as needed. Relentless follow-up ability. Healthcare experience including record keeping and credentialing for licensed staff is strongly preferred.
Key Approaches to the Work:
Efficient Do-er: You enjoy working independently to complete tasks and having your own set of responsibilities to manage; you maintain a sense of urgency, despite having multiple projects moving forward simultaneously, and keep yourself on track to meet deadlines; you work well independently, have excellent time management skills and find solutions when challenges present themselves.
Organized and detail-oriented: You manage lots of details with accuracy and seeming ease; you attend to the details and process and ensure you do accurate and thorough work. You manage interruptions and get right back on track without missing a beat (or a detail).
Strong communicator: You need others to do things, often on a timeline and sometimes that they aren’t’ excited to do. Luckily, you’re an effective and compelling communicator, which means you can rely on your ability to communicate clearly, to build rapport with others, and to ensure you help people understand processes (and consequences if they’re not met or followed). You understand and practice confidentiality.
Inclusion and Equity Champion: Able to actively contribute to a more equitable and inclusive organization. You accept responsibility for your own conduct in upholding an equitable and inclusive workplace.


Primary Areas of Responsibility/Essential Functions:

  • Billing audits
  • Billing research for new items and services
  • Scrubbing and auditing charts for correction and completeness
  • You will provide essential capacity, and support to the Business Services team, acting as the primary point of contact for all referral and prior authorization requests. You will be responsible for liaising with health center staff, other business service staff, payers, pharmacies, and patients in order to ensure patients can access care and medications in line with the expectations of their health insurance requirements. You will may help Health Centers and patients resolve insurance dilemmas and payer contracting questions. You will keep Health Center leadership informed of trends and issues and will assist staff in realizing a reduction in avoidable errors. You will do insurance billing and support through ensuring all prior authorization, referrals, and information about specific insurance coverage or requirements are received prior to care being rendered, and may assist in moving multiple additional processes forward, including:
  • Eligibility denials
  • Collecting outstanding balances

Abortion Care: We all work in abortion care, whether it is referrals, information, education, counseling, performing, scheduling, etc. In this role, you will be work with clinicians to ensure they have the appropriate licensing and with payers so that we are able to provide patient service including abortion care.
Benefits at PPRM include:
A predictable schedule and dedicated individualized paid training
401K/Safe Harbor Contributions (We contribute to your 401K after an allotted period of time)
Medical/Vision/Dental, with extended mental health coverage
Employee Loan Program
Employee Assistance Program and WorkLife Partnership
PPRM Internal Benefits Program
Paid Family Leave/Paid Parental Leave
Generous PTO and Sick Time
Wellness Days
Float Holidays (You pick your holidays)
Bereavement Leave
And More!

COVID-19 Vaccine: PPRM requires that all employees are fully vaccinated as a condition of employment. An employee is considered fully vaccinated two weeks after receiving the second dose of a two-dose vaccine (Pfizer or Moderna) or one dose of a single- dose vaccination (Johnson and Johnson/Janssen). Proof must be uploaded upon starting. You will upload a picture or pdf of your vaccination card(s) on your first day of orientation.
Background Check Required
Planned Parenthood of the Rocky Mountains is an equal employment opportunity employer and is committed to maintaining a non-discriminatory work environment, and does not discriminate against any employee or applicant for employment on the basis of race, color, religion, sex, national origin, age, disability, veteran status, marital status, sexual orientation, gender identity, or any other characteristic protected by applicable law.

About Us:
Planned Parenthood is committed to creating a dynamic work environment that values diversity, equity, inclusion, respect, integrity, customer focus, and innovation. We are committed to creating a welcoming space for all people on our staff, in our health centers, and in our community. We do this by tending to the team, respecting and honoring all people, jumping in, trying and learning, caring for our business, and returning to our mission. Learn More