Planned Parenthood of Central and Western New York · 8 hours ago
Billing Auditor
Rochester,NY,US
Full-time
Onsite
Mid Level
$54K/yr - $63K/yr
3+ years expPlanned Parenthood of Central and Western New York is dedicated to providing health care and education. The Billing Auditor evaluates Revenue Cycle outcomes and works collaboratively with leadership to improve operations and workflows, ensuring billing integrity and achieving revenue cycle goals.
Health CareHospitalNon ProfitPersonal Health
Responsibilities
Evaluates charge capture, claims scrubbing and sliding fee discount practices to ensure efficiency, accuracy, and completeness of encounters, claims and transactions in compliance with payer rules and regulations
Maintains and ensures a disciplined and effective approach to discover root causes of denials, underbilling, overbilling, underpayment, and aging A/R
Reports to Revenue Cycle Management, Affiliate HS/RC Monthly meetings, and Quality Risk Management Committees on trends, findings, and opportunities for improvement detailing findings and high-risk items that leaders should be monitoring
Develops and recommends corrective action plans including work queues which identify and sequence the activities needed to ensure that identified issues are resolved accurately and in a timely manner to meet deadlines
Recommends modifications to established practices and procedures or system functionality based on findings to improve workflows, to standardize processes and maximize reimbursement
Supports the documentation and maintenance of Revenue Cycle Standard Operating Procedures (SOPs)
Supports the documentation of Revenue Cycle training materials and presentations
Works collaboratively with the Revenue Cycle Leadership to ensure effective, consistent, and timely communication across affiliates
Builds and manages relationships with Payers to identify and resolve claim billing and processing issues
Works collaboratively within Revenue Cycle and with other stakeholders across departments and affiliates utilizing both verbal and written communication to improve Revenue Cycle outcomes
Manages individual projects as assigned and provide weekly status reports
Performs data processing, analysis and reporting of Revenue Cycle activities and metrics with supporting detail
Attends and participates in team meetings, and other required meetings or training opportunities
Performs other duties as assigned
Handles confidential and non-routine information with sensitivity
Practices a customer-oriented and team approach in carrying out job responsibilities
Shows respect to all internal and external customers for differences in backgrounds, lifestyles, viewpoints and needs
Qualification
Required
Bachelor's degree in Business or Healthcare Administration or related field preferred
Minimum 3 years of experience in medical billing and collections, including follow-up on unpaid claims, researching insurance claims issues, and appealing to insurance companies for denied claims within standard billing cycle timeframes
Minimum 3 years of experience with computerized billing/receivables system and reports
In-depth knowledge of Governmental and non-Governmental insurance guidelines and other healthcare funding programs
In-depth knowledge of ICD, CPT, and HCPCS coding as well all billing, CCI, MUEs, and other relevant coding/billing guidelines
Ability to read and interpret medical procedures and terminology
Must have excellent communication skills (verbal and written)
Must be sensitive to patient's financial and clinical needs while maintaining the patient's confidentiality
Must be able to multi-task and work in a fast-paced environment effectively under deadlines
Must have exceptional attention to detail and take pride in work
Must demonstrate strong analytical and problem-solving skills
Must be able to work independently and as a team player
Must have strong interpersonal skills that foster a cooperative teamwork environment
Computer skills must include advanced level in Excel and other MS Office programs
Must be able to work a flexible schedule with ability to travel to multiple sites when needed
Must have reliable transportation and/or a valid driver's license not in jeopardy of being revoked
A commitment to PPCWNY's mission, vision and values along with a commitment to providing services to a wide range of clients and to the goals of PPCWNY is essential
Preferred
Certified Professional/Medical Coder or Certified Professional Medical Auditor desired
Experience with NextGen practice management system preferred
Planned Parenthood seeks candidates who are proficient in two or more languages
Benefits
Generous Paid Time Off
10 paid holidays
Affordable medical, dental, and vision options
Health Savings Account or Flexible Spending Account
401(k) with match
And much more!
Company
Planned Parenthood of Central and Western New York
Planned Parenthood of Central and Western New York specializes in reproductive health care services.
Founded in 1971Rochester, New York, USA
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Michelle Casey
President and Chief Executive Officer
Rachel Montpelier
Executive Assistant to the CEO
Recent News
San Bernardino Sun
2025-10-20
Rochester Business Journal
2025-07-25
Rochester Business Journal
2025-05-04
Company data provided by crunchbase