Billing Representative

SB CLINICAL PRACTICE MANAGEMENT PLAN INC; Setauket (NY); Hybrid; USD 32,000 - 40,000; Full time

Job summary

SB CLINICAL PRACTICE MANAGEMENT PLAN INC in East Setauket, NY is seeking a Billing Representative for Stony Brook CPMP Patient Accounts. The role focuses on accurate billing and payer reimbursements, ensuring timely processing of payments and related documents.

You will handle reconsiderations, payer communications, and billing error corrections, while supporting physicians and attorneys. The position operates full time, with standard weekday hours and some remote work at management’s discretion.

Qualifications

• High School Diploma or GED required.
• Minimum of two years medical billing experience or graduation from a medical billing program.
• Excellent expressive and written communication skills.
• Highly organized and detail oriented.
• Proficient in Microsoft Word and Excel.

Responsibilities

• Prepare reconsideration to payers.
• Process payer rejections.
• Review payer payments.
• Complete special department/physician projects.
• Prepare billing error corrections, refunds and itemized bills for patients and attorneys.
• Interact with third party payers for verification of reimbursement benefits and claim status.
• Perform all other duties as assigned by management.

Skills

Excellent communication

Highly organized

Education

High School Diploma/GED

Tools

Microsoft Word

Excel

Job description

Billing Representative - Stony Brook CPMP Patient Accounts

Location: East Setauket, NY; At the manager’s discretion, this role may be eligible for remote work; this position is only available to New York State Residents.

Schedule: Full time

Days/Hours: Monday - Friday; 830 AM - 5 PM

Pay: $23.00 - $28.74

Our compensation philosophy aims to provide marketable compensation programs and to compensate employees based on relevant experience and education. Individual compensation discussions begin during the hiring process and may occur during job review and promotional opportunities. Salaries vary depending on experience, education and current market for the position. Human Resources determines the external and internal equitable salary for each employee. The above salary range (or hiring range) represents Stony Brook CPMP’s good faith and reasonable estimate of the range of possible compensation at the time of posting

SUMMARY

This position requires the incumbent to provide administrative support to CPMP. This position is essential to ensure billing and payer reimbursements are processed accurately.

Job Duties & Essential Functions

• Prepare reconsideration to payers.
• Process payer rejections.
• Review payer payments.
• Complete special department/physician projects.
• Prepare billing error corrections, refunds and itemized bills for patients and attorneys.
• Interact with third party payers for verification of reimbursement benefits and claim status.
• Perform all other duties as assigned by management.

Required Education & Qualifications

• High School Diploma/GED
• Minimum of two years medical billing related experience in a physician’s office or graduation from a medical billing program
• Must have excellent expressive and written communication skills
• Must be highly organized
• Must be proficient in Microsoft Office Word and Excel

Preferred Education & Qualifications

• Computer literate with knowledge of medical insurance policies, reimbursement and medical terminology.
• Experience with insurance websites.
• Must be proficient in Microsoft Office Word and Excel.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to communicate with patients, staff and medical providers. The employee must be able to exchange accurate information in these situations. This position is largely sedentary and requires the employee to remain stationary for a majority of the day. Any additional physical demands will be outlined and provided by management.

The responsibilities and tasks outlined in this job description are not exhaustive and may change as determined by the needs of CPMP.

StaffCo is a Professional Employer Organization, commonly referred to as a PEO, duly organized and registered under the New York Professional Employer Organization law. StaffCo and SUNY have entered into a professional employer agreement under which StaffCo is the employer of Stony Brook Clinical Practice Management Plan employees and responsible for all aspects of employment, including hirings, promotions, disciplines, terminations, the day-to-day direction and supervision of work, as well as labor relations and collective bargaining. StaffCo is fully responsible for providing all payroll and human resources services, including the payment of wages, collecting and reporting payroll taxes and maintaining any and all employee benefits. SUNY Stony Brook Hospital is responsible for the operation of the hospital and provision of health care and is the co-employer as is necessary to conduct its responsibilities and for related licensure, regulatory or statutory requirements and obligations.

Given StaffCo’s employment responsibilities, it is deemed the “employer” for employment and labor law purposes. Thus, the employees are private sector employees of StaffCo, not public sector employees of SUNY. The private sector nature of the StaffCo employees has been approved by NYS Civil Service and upheld in a decision by the US National Labor Relations Board.

CPMP provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, gender identity or expression, or any other legally protected status. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall and transfer, leaves of absence, compensation and training.

CPMP expressly prohibits any form of workplace harassment based on race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, gender identity, or any other legally protected status. Improper interference with the ability of CPMP’s employees to perform their job duties may result in discipline up to and including discharge.