Billing Representative II (Authorizations) - Las Vegas, Nevada

NYU Langone Health • Las Vegas, NV

5h • Onsite

About The Position

We have an exciting opportunity to join our team as a Billing Representative II. Under general direction, this role 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 part of the revenue cycle team. The position also serves as a Brand Ambassador for NYU Langone Health Faculty Group Practice, upholding the mission, vision, and values, and promoting excellence in the patient experience. This involves embodying the core principles of the FGP Service Strategy CARES (Connect, Align, Respond, Ensure, and Sign-Off), greeting patients warmly, collaborating with colleagues for timely resolution of patient interactions, proactively anticipating patient needs, participating in service recovery using the LEARN model, sharing ideas for improvement, and partnering with Patient Access Center and Central Billing Office team members. The role also ensures practice staff are versed in Access Agreement gold standard principles.

Requirements

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

Benefits

• Financial security benefits
• Generous time-off program
• Employee resource groups for peer support
• Holistic employee wellness program focusing on seven key areas of well-being: physical, mental, nutritional, sleep, social, financial, and preventive care.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED