NYU Langone Health is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education. It comprises more than 200 locations throughout the New York area, including five inpatient locations, a children’s hospital, three emergency rooms and a level 1 trauma center. Also part of NYU Langone Health is the Laura and Isaac Perlmutter Cancer Center, a National Cancer Institute designated cancer center, and NYU Grossman School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. For more information, go to nyulangone.org, and interact with us on Facebook, Twitter, YouTube and Instagram.
Position Summary: We have an exciting opportunity to join our team as a Faculty Group Practice Billing Representative III. We have positions available on our Accounts Receivables, Payments & Credits and Authorization teams. In this role, the successful candidate will be responsible for submitting claims and following up on unpaid balances (insurance or patient). This person will also correct errors, enter claim information, submit authorization/pre-certification requests with insurance companies, follow up on denied claims and/or authorizations, and submit appeals as necessary.
* Perform billing tasks assigned by management which may include data entry, claim review, charge review, accounts receivable follow-up, or other related responsibilities.
* Provide input on system edits, processes, policies, and billing procedures to ensure maximization of revenues.
* Perform daily tasks in assigned work queues and according to manager assignments.
* Identify payer, provider credentialing, and/or coding issues and address them with management.
* Follow workflows provided in training classes and request additional training as needed.
* Utilize CBO Pathways as guide for determining actions needed to resolve unpaid or incorrectly paid claims and/or for authorizing procedures in assigned work queue(s) using payer websites, billing system information and training within expected timeframe;
* Review reports to identify revenue opportunities and unpaid claims.
* Adhere to general practices and FGP guidelines on compliance issues and patient confidentiality.
* Communicate with providers, patients, coders, or other responsible persons to ensure that claims are correctly processed by third party payers.
* Work following operational policies and procedures, and regulatory requirements.
* Participate in workgroups and meetings. Attend all required training classes. Escalate issues to management as needed. Maintain confidentiality. Read and apply policies and procedures to make appropriate decisions. Coordinate functions and work cooperatively with others. Explain processes and procedures to others; performs other related duties as assigned.
* Responsible for assisting the professional billing staff within the CBO with difficult and escalated issues.
* Assist department supervisor on special projects and staff training.
* Appeal complex denials through review of payer policies, coding, contracts, and medical records. Utilize subject matter experts as needed.
* Make appropriate corrections to system to satisfy/edit payer requirements and re-submit claims as needed.
* Cross cover other areas in the office as assigned by management including Accounts Receivable/Denials, Customer Service or Authorizations.
Minimum Qualifications: To qualify you must have a High School Diploma or GED. Experience in medical billing, accounts receivable, insurance, or related duties; Knowledge of CPT and ICD10; medical billing software; English usage, grammar and spelling; basic math; 3 years experience in a similar role.
NYU Langone Florida is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online.
If you wish to view NYU Langone Florida’s EEO policies, please click here. Please click here to view the Federal 'EEO is the law' poster or visit https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm for more information. To view the Pay Transparency Notice, please click here.