Job Detail

Medical Collections Specialist Planned Parenthood of Orange and San Bernardino Counties 801 E Katella Ave, Anaheim, CA 92805 Full-time - Medical Billing & Coding

Date Posted: Dec 20, 2021

Job Description

Job details

Job Type
Pulled from the full job description
Disability insurance
Health insurance
Dental insurance
Vision insurance
401(k) matching
Life insurance
Indeed's salary guide
  • Not provided by employer
  • $40.3K to $51.1K per year is Indeed's estimated salary for medical collector at Planned Parenthood in Anaheim, CA.

Full Job Description

Planned Parenthood of Orange and San Bernardino Counties has a full-time opportunity for a Medical Collections Specialist in Anaheim, CA.

The Medical Collections Specialist at PPOSBC and Melody Health assures timely reimbursement of clean claims, corrects denied claims, appeals denied or delayed claims with specific payers in order to receive reimbursement for healthcare claims. Responsible for entering, and correcting medical claims (CPT, CPT II, HCPCS, ICD-9) into a computer system and generating invoices to be sent to the health plans. Responsible for compiling and updating revenue cycle management on payer billing and regulatory updates, NCCI updates for Medicaid, Medicare and health plans. Medical Billing Specialist’s work is focused on all high volume facilities, top 20 payers, and on State Of California’s health programs.

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
Essential Functions: Essential functions encompass the required tasks, duties and responsibilities performed as part of the job and the reason the job exists.
  • Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission.
  • Re-prints and/or re-batches paper and electronic claims for timely re-submission of denied claim.
  • Knowledge of industry standard and Medi-Cal denials reasons/codes.
  • Handle information about patient treatment, diagnosis, and related procedures to ensure clean claim submissions.
  • Know several different coding systems, including Level 1 HCPCS and Level 2 HCPCS.
  • Compile billing, and payer documentation to create training documents.
  • Use computers to read and organize charts.
  • Ensure healthcare facilities are reimbursed for all procedures.
  • Collect, post, and manage patient account payments.
  • Submit claims to insurance within corporate charge posting lag.
  • Process payments from insurance companies.
  • Follow up on claim submissions to determine batch acceptance, rejection, or denial.
  • Researches, correct, resolve, resubmit and appeal denied claims/services.
  • Corresponds with insurance companies to resolve the issue; submits appeals per payer requirements.
  • Maintains collections rate for assigned payers at or above 70% of allowed charges.
  • Communicate with RCM leadership about payer updates, changes, and requirements.
  • Review delinquent accounts and call responsible party(ies) for collection purposes.
  • Sort and file paperwork from health plans, patient charts, and payment correspondence.
  • Investigate insurance fraud and report if found.
  • Maintain strict confidentiality.
  • Other duties as assigned by Director RCM.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed may be made to enable individuals with disabilities to perform the essential functions.
  • Strong commitment to quality healthcare and excellent customer service.
  • 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
  • Knowledge of MS Excel.
  • Ability to maintain confidentiality.
  • Accuracy and attention to detail is essential.
  • Proficient in MS Office: Excel, MS Word, Outlook.
  • Professional demeanor at all times.
  • Availability to work flexible hours including weekend.
  • Experience with electronic practice management system and electronic health record system (minimum 1 year).
  • Three 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.
  • Medical terminology.
  • Associate’s or Bachelor’s Degree preferred or equivalent experience in related field.
  • Computer database management (electronic practice management system). EclinicalWorks/NextGen experience preferred.
  • 3+ years experience in Billing and coding procedures.
  • 3+ years experience with insurance billing and reimbursement procedures.
  • 2+ years’ experience with HIPAA 5010 transaction standards.
  • 2+ years claims follow-up/appeals and health plan Accounts Receivable management for specific payers.
All employees are required to be fully vaccinated for COVID-19 unless a reasonable accommodation is approved for a medical/disability or religious exemption.

Planned Parenthood/Orange and San Bernardino Counties is an equal opportunity employer. Applicants will receive consideration for employment without regard to race, color, ancestry, national origin, religion, creed, equal pay, age, disability, sex, gender, sexual orientation, gender identity, gender expression, medical condition, genetic information, marital status, military, veteran status or any other federal or state protected class
We are committed to building and maintaining an inclusive workplace that values diversity, equity, and inclusion.



801 E Katella Ave, Anaheim, CA 92805

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