ABOUT NYU LANGONE HEALTH
NYU Langone Health is a world-class, patient-centered, integrated academic medical center. Ranked as the #1 Hospital for quality and patient safety by Vizient, Inc., and with 10 clinical specialties among the top 10 in the nation according to U.S. News & World Report, NYU Langone’s culture is rooted in excellence in patient care, education, and research. NYU Langone comprises more than 320 locations throughout the New York area and in Florida, including six inpatient locations, a children’s hospital, and four emergency rooms. Also part of NYU Langone Health is the Laura and Isaac Perlmutter Cancer Center, a National Cancer Institute designated comprehensive cancer center, NYU Grossman School of Medicine, and NYU Grossman Long Island School of Medicine. For more information, go to nyulangone.org, and interact with us on LinkedIn, Glassdoor, Indeed, Facebook, Twitter, YouTube, and Instagram.
Working at NYU Langone Health
At NYU Langone Health, there are numerous areas for you as a leadership professional to make an impact on our organization. As one of the nation’s leading medical centers, we need bright, innovative people to step up and take charge of the many initiatives currently taking place here. From our brand new 830,000-square-foot Helen L. and Martin S. Kimmel Pavilion to our new 16 story Science Building, NYU Langone Health is ripe with career-opportunities that are sure to transform the way we think about medical care.
Salaries shown on independent jobs related websites reflect market averages and do not represent information obtained directly from NYU Langone. We invite and encourage each candidate to discuss salary/hourly specifics during the application and hiring process.
Position Summary:
We have an exciting opportunity to join our team as a Billing Representative II.
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 as a part of the revenue cycle team.
Job Responsibilities:
- Perform other duties as needed.
- 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 workqueue(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.
- 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; 2 years experience in a similar role.