Billing Representative III - Boynton Beach, Florida

NYU Langone Health • Boynton Beach, FL

2d

About The Position

The Billing Representative III performs advanced billing and financial clearance functions under general direction. Responsibilities include claims management, complex denial resolution, insurance authorizations and precertifications, and patient cost estimates. The role supports colleagues with escalated issues and participates in training, workgroups, and process-improvement efforts.

The representative works assigned queues and follows established workflows, policies, procedures, and regulatory requirements. They review reports for revenue opportunities, unpaid claims, and authorization or financial-clearance delays; communicate with providers, patients, coders, and other responsible parties; and identify payer, credentialing, or coding issues for resolution with management. The position also assists with difficult cases, staff training, special projects, and coverage across other office areas as assigned.

The role promotes a positive patient and colleague experience by communicating professionally, anticipating patient needs, collaborating with internal and external teams, and applying the department’s CARES service principles and LEARN service-recovery model. The representative maintains confidentiality and escalates issues as appropriate.

Requirements

• High school diploma or GED.
• Three years of experience in a similar role.
• Experience in medical billing, accounts receivable, insurance, or related duties.
• Knowledge of CPT and ICD-10.
• Knowledge of medical billing software.
• Knowledge of English usage, grammar, and spelling.
• Basic math skills.
• Light, accurate keyboarding skills.
• Strong verbal and written communication skills and ability to collaborate across departments.
• Strong critical-thinking and effective-listening skills.
• Professional demeanor and positive attitude.
• Time-management skills.
• Ability to develop and maintain effective working relationships with peers, staff, and leadership.
• Ability to communicate effectively with all levels of the organization.

Nice To Haves

• Typing speed of 35 words per minute or greater on the typing assessment administered before onboarding.

Responsibilities

• Perform assigned billing work, which may include data entry, claim review, charge review, accounts receivable follow-up, and related duties.
• Provide input on system edits, processes, policies, and billing procedures to help maximize revenue.
• Complete daily tasks in assigned work queues according to manager assignments.
• Identify payer, provider credentialing, and coding issues and address them with management.
• Follow trained workflows and seek additional training when needed.
• Use CBO Pathways, payer websites, billing-system information, and training to resolve unpaid or incorrectly paid claims and authorize procedures within expected timeframes.
• Review reports for revenue opportunities, unpaid claims, and delays in authorizations or financial clearance.
• Follow departmental compliance practices and protect patient confidentiality.
• Communicate with providers, patients, coders, and other responsible parties to support correct processing of claims by third-party payers.
• Work in accordance with operational policies, procedures, and regulatory requirements.
• Participate in workgroups and meetings, attend required training, and escalate issues to management as needed.
• Read and apply policies and procedures, coordinate functions, and work cooperatively with others.
• Assist other billing representatives with difficult and escalated issues.
• Assist the department supervisor with special projects and staff training.
• Appeal complex denials by reviewing payer policies, coding, contracts, and medical records, and consult subject matter experts as needed.
• Cross-cover other office areas as assigned, including Accounts Receivable/Denials, Customer Service, or Authorizations.
• Perform other related duties as assigned.
• Apply the CARES service principles in patient and colleague interactions.
• Greet patients professionally and clearly communicate steps in the interaction as appropriate.
• Collaborate with colleagues and site management to support positive experiences and timely resolution of patient interactions and inquiries.
• Anticipate patient needs and participate in service recovery using the LEARN model; escalate concerns to leadership as appropriate.
• Share opportunities to improve patient experience and access with appropriate leadership.
• Partner with internal and external team members to promote collaboration and a positive patient experience.
• Help ensure practice staff understand the Access Agreement gold-standard principles.

Benefits

• Comprehensive benefits and wellness package.
• Financial security benefits.
• Generous time-off program.
• Employee resource groups for peer support.
• Holistic employee wellness program covering physical, mental, nutritional, sleep, social, financial, and preventive-care well-being.

What This Job Offers

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