Billing Representative I (Authorizations) - Central Billing Offic...
NYU Langone Health - Boynton Beach, Florida, United States, 33435Work at NYU Langone Health
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Overview
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.Job Responsibilities:Perform other duties as needed.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 a guide for determining actions needed to resolve unpaid or incorrectly paid claims and/or for authorizing procedures in assigned work queues using payer websites, billing system information, and training within the 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; perform other related duties as assigned.Make appropriate corrections to the system to satisfy/edit payer requirements and re-submit claims as needed.Cross-cover other areas in the office as assigned by management including Accounts Receivable/Denials, Customer Service, or Authorizations.Minimum Qualifications:To qualify, you must have a High School Diploma or GED. Knowledge of CPT and ICD10 utilized in medical billing, or medical billing experience a plus, English usage, grammar and spelling; basic math. Light, accurate keyboarding skills are required. Candidates must receive a score of 35 words per minute (wpm) or greater on the typing assessment that will be administered before onboarding.
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