Billing Representative II (Authorizations) - Boynton Beach, Florida

NYU Langone Medical Center • Boynton Beach, FL

78d

About The Position

We have an exciting opportunity to join our team as a Billing Representative II. 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 as a part of the revenue cycle team.

Requirements

• High School Diploma or GED.
• Experience in medical billing, accounts receivable, insurance, or related duties.
• Knowledge of CPT and ICD10.
• Experience with medical billing software.
• Proficient in English usage, grammar and spelling.
• Basic math skills.
• 2 years' experience in a similar role.

Nice To Haves

• Light, accurate keyboarding skills required.
• Candidates must receive a score of 35 words per minute (wpm) or greater on the typing assessment that will be administered prior to onboarding.
• Ability to effectively communicate with all levels of the organization.

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 workqueue(s) 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.

Benefits

• Comprehensive benefits and wellness package.
• Access to financial security benefits.
• Generous time-off program.
• Employee resources groups for peer support.
• Holistic employee wellness program focusing on physical, mental, nutritional, sleep, social, financial, and preventive care.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Hospitals
• Education Level: High school or GED
• Number of Employees: 1,001-5,000 employees