Boynton Beach, Florida

NYU Langone Health




Position Summary:
We have an exciting opportunity to join our team as a FGP Billing Rep III.

In this role, the successful candidate 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. Assists with other related tasks including medical record requests, reviewing accounts, and billing projects.

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.
  • 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;
  • 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.
  • 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.

Minimum Qualifications:
To qualify you must have a High School Diploma or GED. Experience in medical billing, accounts receivable, insurance, or related duties; Knowledge of CPT and ICD10; medical billing software; English usage, grammar and spelling; basic math; 2 years experience in a similar role.

Preferred Qualifications:
Experience with precertifications/authorizations preferred.

Boynton Beach, Florida

NYU Langone Health, a world-class, patient-centered, integrated academic medical center, is one of the nation’s premier centers for excellence in clinical care, biomedical research, and medical education. Located in the heart of Manhattan, NYU Langone is composed of five hospitals—Tisch Hospital, its flagship acute care facility; Rusk Rehabilitation; the Hospital for Joint Diseases, the Medical Center’s dedicated inpatient orthopaedic hospital; NYU Lutheran Medical Center, a full-service, 450-bed teaching hospital located in Brooklyn, and Hassenfeld Children’s Hospital, a comprehensive pediatric hospital supporting a full array of children’s health services across the Medical Center. Also, part of NYU Langone is NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history, and the Laura and Isaac Perlmutter Cancer Center, a National Cancer Institute–designated cancer center. The Medical Center’s trifold mission to serve, teach, and discover is achieved 365 days a year through the seamless integration of a culture devoted to excellence in patient care, education, and research.