Position Summary:
We have an exciting opportunity to join our team as a Billing Representative III.

Under general direction submits claims Follows up on unpaid balances insurance or patient corrects errors enters claim information submits authorization/precertification requests with insurance companies follows up on denied claims and/or authorizations and submits appeals as necessary

Job Responsibilities:

Cross cover other areas in the office as assigned by management including Accounts Receivable/Denials Customer Service or AuthorizationsPerform billing tasks assigned by management which may include data entry claim review charge review accounts receivable follow up or other related responsibilitiesProvide input on system edits processes policies and billing procedures to ensure maximization of revenuesPerform daily tasks in assigned work queues and according to manager assignmentsIdentify payer provider credentialing and/or coding issues and address them with managementFollow workflows provided in training classes and request additional training as neededUtilize CBO Pathways as guide for determining actions needed to resolve unpaid or incorrectly paid claims and/or for authorizing procedures in assigned workqueue s using payer websites billing system information and training within expected timeframeReview reports to identify revenue opportunities and unpaid claimsAdhere to general practices and FGP guidelines on compliance issues and patient confidentialityCommunicate with providers patients coders or other responsible persons to ensure that claims are correctly processed by third party payersWork following operational policies and procedures and regulatory requirementsParticipate 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 assignedResponsible for assisting the professional billing staff within the CBO with difficult and escalated issuesAssist department supervisor on special projects and staff trainingAppeal complex denials through review of payer policies coding contracts and medical records Utilize subject matter experts as neededMake appropriate corrections to system to satisfy/edit payer requirements and re submit claims as needed

Patient Experience Access

Serves as NYU Langone Health Faculty Group Practice Brand Ambassador by upholding the NYULH Mission vision and values and promoting excellence in the patient experience during every encounterDrives consistency in every patient and colleague encounter by embodying the core principles of our FGP Service Strategy CARES Connect Align Respond Ensure and Sign OffGreets patients warmly and professionally stating name and role and clearly communicates each step of the care/interaction as appropriateWorks collaboratively with colleagues and site management to ensure a positive experience and timely resolution for all patient interactions and inquiries whether in person by phone or via electronic messagingProactively anticipates patient needs and participates in service recovery by applying the LEARN model Listen Empathize Apologize Resolve Notify and escalates to leadership as appropriateShares ideas or any observed areas of opportunity to improve patient experience and patient access with appropriate leadership i e ways to optimize provider schedules how to minimize delays increase employee engagement etcPartners with Patient Access Center and Central Billing Office team members to support collaboration and promote a positive patient experienceTakes a proactive approach in ensuring that practice staff are fully versed in the Access Agreement gold standard principles

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 Light accurate keyboarding skills required Candidates must receive a score of 35 words per minute wpm or greater on the typing assessment that will be administered prior to onboarding

Qualified candidates must be able to effectively communicate with all levels of the organization.

NYU Langone Nevada 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 Nevada'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.