Planned Parenthood Los Angeles is seeking an experienced Senior Manager, Medical Coding, Contracts Implementation and Compliance. This position is responsible for PPLA Coding, all PPLA Contract Implementation and the Commercial Contract Revenue Cycle. Manages the Contract Billing Specialist, the Senior Contract Insurance Specialist. Works closely with the Director of Revenue Cycle and Insurance Verification and identifies coding & billing opportunities and how to resolve/further educate the Revenue Cycle & Patient Services staff members. Participates as the Coding subject matter expert and Revenue Cycle representative on various PPLA performance improvement teams.
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 57+ 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:
- High school diploma or equivalent required.
- Medical Coding certificate required Certified by AAPC or AHIMA.
- Four (4) years’ experience as a Medical Biller/Coder required.
- Five (5) year experience coding/billing Medi-Cal managed care plans and various medical groups.
- Medi-Cal coding compliance experience required.
- Familiar with coding for medications.
- Minimum three (3) years of supervisory experience required
About the Position:
- Abortion patients are cared for at each of our health centers, and in part through the administrative, support, and other non-clinical services provided at all PPLA locations, and by all PPLA employees. Supporting these critical services is an essential job duty, and a fundamental responsibility of all employees and contractors.
- Complete understanding of medical billing and coding - documentation, electronic claim filing, ICD-9 (ICD-10), CPT codes, and Revenue Cycle
- Knowledge with various payors – Family PACT, Medi-CAL, HMOs, IPAs, PPOs, POS, EPO, Medicare, etc.
- Ability to work independently and as a team member.
- Ability to communicate effectively both written and orally.
- Ability to read and implement written instructions.
- Able to research/problem solve complex billing coding issues.
- Availability to work flexible hours, including weekends and evenings as required.
- Ability and willingness to travel within Los Angeles County
- Reliable means of transportation for onsite and off-site work
- If using a personal vehicle to drive for work purposes, a valid CA driver license and current auto insurance in compliance with the minimum requirements of CA vehicle code are required.
- Respond to outside compliance questions, complaints, and inquiries related to Charging, Coding, CDM and Denial Items.
- Ensure the timeliness of processing and correction of rejected claims.
- Perform monitoring and follow-up to ensure timely repayment is made for all identified overpayments received from government agencies, health plans and patients.
- Review changes in pricing, CPTs, HCPCs, rev codes, etc. for accuracy and compliance with all applicable charging and billing guidelines. Ensure teams stay informed of payor and/or regulatory updates and create action plans to accommodate changes as needed.
- Manages all PPLA Contract Implementation.
- Manages the Revenue Cycle for all Commercial Contracts.
- Collaborates with the Revenue Cycle management staff members to ensure that all claims are coded & billed out promptly and will analyze and determine any correctable rejection reasons and contact clinic for any required information.
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
- Hiring range: $95,167 - $114,200 per year (Exempt)
Compensation Philosophy and Position Hiring Range:
At Planned Parenthood Los Angeles we continuously work towards our values of Justice, Equity, Diversity, and Inclusion including with our compensation philosophy. PPLA recognizes that decisions about pay and benefits have significant impact on staff, so we are committed to ensuring all positions are rooted in a description that identifies competencies, duties, responsibilities and qualifications, and that they are compensated equitably which takes into account both internal organizational equity and market compensation data for similar roles.
Equal Employment Opportunity will be afforded to all applicants and other covered persons without regard to protected characteristics, including their perceived protected characteristic. Protected categories include: race (including traits historically associated with race, including but not limited to, hair texture and protective hair styles such as, braids, locs, and twists as examples but not exhaustive list), color, religion or religious creed (including religious belief, observation, practice, dress, and grooming practices), national origin, ancestry, physical or mental disability, medical condition, genetic information, marital status, sex (including pregnancy, childbirth, breastfeeding/chestfeeding, or related medical conditions), reproductive health decision-making, gender, gender identity, gender expression, age (40 years and over), sexual orientation, veteran and/or military status (including past, current or prospective service in the uniformed service), and any other characteristic protected under applicable federal, state or local law. PPLA will consider for employment qualified applicants with criminal histories in accordance with the requirements of Los Angeles Fair Chance Initiative for Hiring.
