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NYU Langone Health seeks a Billing Representative III to join their Central Billing Office in Las Vegas, NV. The successful candidate will handle claims submission, resolve billing issues, and ensure accurate payment processes while delivering outstanding patient experience. This role requires 3 years of experience and a high school diploma, emphasizing attention to detail and strong communication skills.
We have an exciting opportunity to join our team as a B illing Representative III (A/R) - Central Billing Office Onsite - Las Vegas, NV.
In this role, the successful candidate will be responsible for submitting claims, following up on unpaid balances from insurances and payments, corrects errors and 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 Authorizations
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 and 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
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 encounter
Drives consistency in every patient and colleague encounter by embodying the core principles of our FGP Service Strategy CARES Connect Align Respond Ensure and Sign Off
Greets patients warmly and professionally stating name and role and clearly communicates each step of the care/interaction as appropriate
Works 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 messaging
Proactively anticipates patient needs and participates in service recovery by applying the LEARN model Listen Empathize Apologize Resolve Notify and escalates to leadership as appropriate
Shares 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 etc.
Partners with Patient Access Center and Central Billing Office team members to support collaboration and promote a positive patient experience
Takes a proactive approach in ensuring that practice staff are fully versed in the Access Agreement gold standard principles
Minimum Qualifications:
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.
Required Skills:
Required Skills
Required Experience