Position Summary:
We have an exciting opportunity to join our team as a Billing Representative I.
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:
- Perform other duties as needed
- Perform billing tasks assigned by management which may include data entry claim review charge review accounts receivable follow or other related responsibilities
- Provide input on system edit processes policies and billing procedures to ensure the 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 a 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 the 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; perform other related duties as assigned
- Make appropriate corrections to the 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 Knowledge of CPT and ICD10 utilized in medical billing or medical billing experience plus English usage grammar and spelling; and basic math.
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.