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NYU Langone Health · 12 hours ago

Billing Representative III (A/R) - Boynton Beach, Florida

Boynton Beach, FL

Full-time

Onsite

Mid Level

3+ years exp

NYU Langone Health is seeking a Billing Representative III to join their team. This role involves performing advanced billing and financial clearance functions, including claims management and denial resolution, while also providing support and training to staff. The representative will work to ensure correct processing of claims and improve patient experiences.

EducationHealth CareHospitalMedicalNon Profit

Growth Opportunities

Responsibilities

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, unpaid claims, delays in obtaining authorizations/financial clearance

Adhere to general practices and departmental 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

Responsible for assisting other billing representatives with difficult and escalated issues

Assist department supervisor with special projects and staff training

Appeal complex denials through review of payer policies, coding, contracts, and medical records. Utilize subject matter experts as needed

Cross cover other areas in the office as assigned by management including Accounts Receivable/Denials, Customer Service or Authorizations

Other related duties as assigned

Drives consistency in every patient and colleague encounter by embodying the core principles of our Billing Department 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 internal and external 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