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Contract Billing Specialist (CPC) - Los Angeles, CA Job in Los Angeles, California

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Job Title: Contract Billing Specialist (CPC) - Los Angeles, CA

Employer:	Planned Parenthood Los Angeles
Type:	FULL TIME
Skills:	revenue cycle,billing,contracts
Specialties:	healthcare
Required Certifications:	CPC
Required Experience:	3 to 4 years
Location:	Los Angeles 90007, CA, US
Date Posted:	12/4/2020

Planned Parenthood Los Angeles is seeking an experienced Contract Billing Specialist (CPC or CCS) with excellent customer service skills to work full-time in our Downtown Los Angeles Headquarters. The Contract Billing Specialist is responsible for the implementation and maintenance of payer contracts and payer fee schedules. Also responsible for the interpretation, translation, and completion of all processes related to maintaining negotiated fees or rates. In charge of updating any applicable contract files and providing timely responses in regards to any issues raised by payers, clinic operations, and/or the revenue cycle team.

Over one hundred years ago, Planned Parenthood was founded on the idea that everyone should have the information and care they need to live strong, healthy lives and fulfill their dreams. Founded 52+ years ago, Planned Parenthood Los Angeles is one of the largest providers of reproductive health care services in Los Angeles County. The Planned Parenthood Los Angeles (PPLA) team works together to provide high-quality, affordable reproductive health care to women, men, and young people across Los Angeles County. At PPLA, you will discover a culture of like-minded individuals who are eager to make positive contributions to their community and to the Planned Parenthood mission.

Our Ideal Candidate will have the following qualifications:

Associate’s degree preferred or an equivalent combination of education and/or experience
At least 4 years of experience in Revenue Cycle, preferably Medi-Cal Managed Care required
Certified Coder (CPC or CCS)
Solid understanding of Contract Lifecycle: Credentialing, Implementation, Renewals, Amendments, Regulations/Compliance, and Assignment
Knowledge of health care payment methodologies; Payer contract experience preferred
Strong understanding of managed care, delivery systems, and reimbursement
Proficient in the Microsoft Office Suite including Intermediate or Advanced Excel skills

About the position:

Create and maintain contract files
Interpret internal and external contract documentation such as executed contracts
Coordinate with internal departments to execute components of contracts like medical policies
Implement updates and additions to the system
Aid in the resolution of contractual discrepancies received via avenues like audit reports or reconciliation files
Track completed work and request documents from revenue cycle and clinic operations departments
Work collaboratively with internal stakeholders to evaluate and monitor contract performance to determine the need for amendments or extensions of contracts
Identify, collect, and determine root causes of underpaid claims by auditing payer performance and analyzing actual payments of payers to ensure contract compliance
Initiate and follow through with all relevant parties to ensure corrective actions are implemented (i.e., pursue underpayments, adjust expected reimbursement, address billing issues, negotiate settlements, etc.) according to payer specific processes
Respond to payment discrepancies by creating appeal letters and articulating contract provisions to representatives from third party payers; work directly with payer to recover payments
Generate monthly and ad hoc reports for management as requested
Coordinate with other departments to ensure that expected reimbursement rules are up-to-date and accurate
Maintain a schedule of key update dates for expected reimbursement rules and yearly increases for contracts
Accurately identify payment variances and feed underpayment workflow and resolution
Coordinate with plans to resolve issues of contract interpretation affecting rate schedules
Ensure new rates for health plan agreements are successfully communicated within the organization
Ensure that contracts are properly reviewed, executed, and uploaded into the contract database
Ensure that plans are compliant with provider directory locations and attestations, rate loading, and other operational terms in accordance with contract effective date
Facilitate the review and submission of credentialing deliverables to payers

Generous salary and benefits package includes:

Medical, dental, and vision coverage options for you and eligible dependents
Free basic life/AD&D policy with additional voluntary coverage options
Short Term Disability, Critical Illness and Accident policies
403(b) Retirement plan with up to 3% employer match
Medical and Dependent Flexible Spending Account plans
Public Transportation and Commuter Pre-Tax Reimbursements
Generous vacation, sick, and holiday benefits

Planned Parenthood Los Angeles is an Equal Employment Opportunity and Affirmative Action Employer. We will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of Los Angeles County Ordinance No. 184852.