Pharmacy Claims Coordinator_Revenue Cycle Operations

Why Planned Parenthood?

Working at Planned Parenthood of the Great Northwest & the Hawaiian Islands, Indiana, & Kentucky is more than a job. It provides the opportunity to contribute to our powerful mission and perform meaningful work.

In healthcare services, this means a commitment to providing the absolute best in patient care and education. Our exceptional health center staff drives our mission forward by upholding our acclaimed customer service & confidentiality standards, and working to create a safe, judgement-free space for anyone seeking Planned Parenthood services.

As an organization, we are focused on equity, diversity and inclusion. Specifically, we recognize that profound racism impacts the education, health and wellbeing of people in our communities and we are actively working to address all forms of oppression. We believe our employees should reflect the diversity of the populations we serve, including racial and ethnic diversity. People of color are strongly urged to apply.

About this position:
Under the general supervision of the Revenue Cycle Supervisor, accurately bills pharmacy benefit management and processes enrollment tasks for the Refill Center. Accurately bills pharmacy benefit management (PBM) plans in order to receive maximum reimbursement. Process enrollment tasks for Refill Center. Accurately enters pharmacy claims into pharmacy billing system. Responds to health center and patient inquiries regarding pharmacy claims and refill transactions.

This is a FT hourly position working Monday - Friday with 7:30am - 3pm PST standard hours.

While this is not a remote position, currently RCO staff is required to work out Seattle office 1 day a week and remotely the rest of the week. Future remote work may adjust for this role.

What you’ll be doing:
Monitors the practice management system for patient refill tasks, processes the tasks according to department procedures.
Adheres to time sensitive deadlines.
Utilizes practice management system to identify outstanding pharmacy charges, accurately enters the charges into the pharmacy billing system as claims.
Notes patient accounts within the practice management system with expected reimbursement from PBM payer and bills patient for any cost sharing amounts.
Identifies and documents maximum birth control allowed under patient’s pharmacy benefits.
Researches and resolves issues with pharmacy coverage.
Follows-up on pharmacy claim rejections upon receipt with PBM plan.
Posts pharmacy payments.
Provides information by responding to inquiries from patients and health center staff.in accordance with the PPGNHI customer service standards.
Completes work within authorized time to assure compliance with departmental standards.
Consistently meets quality and quantity standards.
Works collaboratively with the RCO team to maximize and facilitate efficient and accurate billing.

We’ll trust you to:
Adhere to the PPGNHAIK code of conduct and all policies, procedures and protocols.
Demonstrate and maintain a high degree of professionalism and ability to maintain client confidentiality.
Take action to support the affiliate’s commitment to equity, diversity and inclusion.
Support and act in accordance with the PPGNHAIK customer service standards.
Value continuous learning and seek ongoing training and development.
Value team work, flexibility and adaptability; embrace change.

You’ll need to have:
High school diploma or equivalent.
Basic knowledge of medical insurance and/or pharmacy billing and payment processing.
Proficient computer skills including Microsoft Office and electronic medical records.
Demonstrated ability to quickly learn and utilize software programs and multiple databases/

Proof of current COVID-19 Vaccine and proof of recent Influenza Vaccine are required for employment with PPGNHAIK.

Perks:
As part of our total rewards package, we offer meaningful work, promotional opportunities, and competitive compensation.
Our attractive benefits package includes medical, dental, and vision coverage for you and eligible dependents, life insurance, short and long term disability coverage, as well as a retirement plan with matching contributions by employer. For additional information regarding compensation, pay scales, or total rewards, please reach out to jobs@ppgnhi.org.

Next Steps:
Please click apply now below to submit an application and resume. Once your information has been reviewed by our recruitment team, we will reach out by telephone and email to schedule an interview for all qualified applicants. Please continue to check your spam folder for all email communications that may come from our organization.

Equal opportunity employment
PPGNHAIK is an equal opportunity employer and seeks to recruit persons of diverse backgrounds and to support their retention and advancement within the organization. Justice is one of our core values, and we are committed to fostering a workplace culture inclusive of people with respect to their race, ethnicity, national origin, gender/gender identity, sexual orientation, socioeconomic status, veteran status, marital status, age, disabilities, political affiliation, religious beliefs or any other characteristic. Our commitment to justice and diversity also means providing a work environment that is welcoming, respectful and engaging.

Racism deeply impacts the health and wellbeing of our communities, compounding existing disparities and creating intersectional barriers. We strive to name and address these barriers through community engagement and assessment, relevant and effective policy creation, and organizational accountability methods. We support initiatives that address all forms of oppression, however, maintaining an explicit focus on race is essential to advancing equity across our communities. Improving outcomes for people of color will improve outcomes for everyone.

Perks
As part of our total rewards package, we offer meaningful work, generous time off and benefits, promotional opportunities, and competitive compensation. Our attractive benefits package includes medical, dental and vision coverage for you and eligible dependents, life insurance, short and long term disability coverage, as well as a retirement plan with matching contributions by employer. We also provide transportation benefits at eligible locations. For additional information regarding compensation, pay scales, or total rewards, please reach out to hr.contacts@ppgnhi.org.

Equal opportunity employment
PPGNHI is an equal-opportunity employer and seeks to recruit persons of diverse backgrounds - and to support their retention and advancement within the organization. We are committed to fostering a workplace culture inclusive of people with respect to their race, ethnicity, national origin, gender/gender identity, sexual orientation, socio-economic status, veteran status, marital status, age, disabilities, political affiliation, religious beliefs or any other characteristic.

Job Type: Full-time