NYU School of Medicine is one of the nation's top-ranked medical schools. For 175 years, NYU School of Medicine has trained thousands of physicians and scientists who have helped to shape the course of medical history and enrich the lives of countless people. An integral part of NYU Langone Health, the School of Medicine at its core is committed to improving the human condition through medical education, scientific research, and direct patient care. For more information, go to med.nyu.edu, and interact with us on Facebook, Twitter and Instagram.
We have an exciting opportunity to join our team as a FGP Billing Rep (35).
In this role, the successful candidate Under general direction, bill, follows-up, correct, and enter claim information in the billing system as assigned by management.
* Responsible for leading Billing Representatives in the absence of their supervisor.
* Make appropriate corrections to system to satisfy/edit payer requirements and re-submit claims as needed.
* Appeal complex denials through review of payer policies, coding, contracts, and medical records.
* Work closely with provider offices on patient issues.
* Assist department supervisor on special projects and staff training.
* Responsible for assisting the professional billing staff within the CBO with difficult and escalated issues.
* 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.
* Work following operational policies and procedures, and regulatory requirements.
* Ensure that items in assigned work queue(s) are resolved within required timeframes using payer website, billing systems, and CBO pathways.
* Communicate with providers, patients, coders, or other responsible persons to ensure that claims are correctly processed by third party payers.
* Adhere to general practices and FGP guidelines on compliance issues and patient confidentiality.
* Request coding guidance as needed.
* Review and resolve uncollected accounts and prepares charge corrections.
* Complete monthly action plans.
* Review reports to identify revenue opportunities and unpaid claims.
* Enter account notes using standard formatting.
* Utilize CBO Pathways as guide for determining actions needed to resolve unpaid or incorrectly paid claims.
* Follow workflows provided in training classes and request additional training as needed.
* Identify payer and provider credentialing issues and addresses them with management.
* Perform daily tasks in assigned work queues and according to manager assignments.
* Provide input on system edits, processes, policies, and billing procedures to ensure maximization of revenues.
* Perform billing tasks assigned by management which may include data entry, claim review, charge review, accounts receivable follow-up, or other related responsibilities.
To qualify you must have a High School Diploma. Experience in medical billing, A/R, insurance, or related duties; Knowledge of CPT and ICD9 utilized in medical billing; medical billing software; healthcare billing including Medicare, Medicaid, or other third party payers; terminology utilized in medical billing; English usage, grammar and spelling; basic math.
Qualified candidates must be able to effectively communicate with all levels of the organization.
NYU School of Medicine provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.
NYU School of Medicine 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 School of Medicine's EEO policies, please click here. Please click here to view the Federal \"EEO is the law\" poster or visit for more information. To view the Pay Transparency Notice, please click here.* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.
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