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Position Summary:

We have an exciting opportunity to join our team as a FGP Senior Billing Rep (35).

In this role, the successful candidate Under general direction, bill, follows-up, correct, and enter claim information in the billing system as assigned by management.

Job 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 and provider credentialing issues and addresses 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.
• Enter account notes using standard formatting.
• Review reports to identify revenue opportunities and unpaid claims.
• Complete monthly action plans.
• Review and resolve uncollected accounts and prepares charge corrections.
• Request coding guidance as needed.
• 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.
• Ensure that items in assigned work queue(s) are resolved within required timeframes using payer website, billing systems, and CBO pathways.
• 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.
• Responsible for assisting the professional billing staff within the CBO with difficult and escalated issues.
• Assist department supervisor on special projects and staff training.
• Work closely with provider offices on patient issues.
• Appeal complex denials through review of payer policies, coding, contracts, and medical records.
• Make appropriate corrections to system to satisfy/edit payer requirements and re-submit claims as needed.
• Responsible for leading Billing Representatives in the absence of their supervisor.

Minimum Qualifications:

To qualify you must have a High School Diploma. Experience in medical billing, A/R, insurance, or related duties; Knowledge of CPT and ICD9 utilized in medical billing; medical billing software; healthcare billing including Medicare, Medicaid, or other third party payers; terminology utilized in medical billing; English usage, grammar and spelling; basic math; 2 years' experience in a similar role.

Qualified candidates must be able to effectively communicate with all levels of the organization.

NYU School of Medicine provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.

NYU School of Medicine is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online.
If you wish to view NYU School of Medicine's EEO policies, please click here. Please click here to view the Federal 'EEO is the law' poster or visit https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm for more information. To view the Pay Transparency Notice, please click here.