NYU Langone Health
Billing Representative III (Authorizations) - Las Vegas, Nevada
NYU Langone Health, Las Vegas, Nevada, us, 89105
Billing Representative III (Authorizations) - Las Vegas, Nevada
Join NYU Langone Health as a Billing Representative III on our Authorizations team. In this role you will submit claims, follow‑up on unpaid balances (insurance or patient), correct errors, enter claim information, request authorizations/pre‑certifications, handle denied claims, and submit appeals as needed. You will work under general direction and support the team’s billing workflow.
Job Responsibilities
Cross‑cover other areas in the office as assigned (Accounts Receivable/Denials, Customer Service, or Authorizations).
Perform billing tasks assigned by management including data entry, claim review, charge review, accounts receivable follow‑up, and 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 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 to determine actions needed to resolve unpaid or incorrectly paid claims and/or to authorize procedures in assigned work queues, using payer websites, billing system information, and training within expected timeframes.
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 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, and escalate issues to management as needed. Maintain confidentiality and coordinate functions with others.
Assist the professional billing staff within the CBO with difficult and escalated issues.
Assist the 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 the system to satisfy/edit payer requirements and re‑submit claims as needed.
Patient Experience & Access
Serve as NYU Langone Health Faculty Group Practice Brand Ambassador by upholding the NYULH Mission, vision, and values and promoting excellence in the patient experience.
Drive 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).
Greet patients warmly and professionally, stating name and role, and clearly communicate each step of the care/interaction as appropriate.
Work collaboratively with colleagues and site management to ensure a positive experience and timely resolution for all patient interactions.
Proactively anticipate patient needs, participate in service recovery by applying the LEARN model (Listen, Empathize, Apologize, Resolve, Notify), and escalates to leadership as appropriate.
Share ideas or observed areas of opportunity to improve patient experience and patient access with appropriate leadership.
Partner with Patient Access Center and Central Billing Office team members to support collaboration and promote a positive patient experience.
Take a proactive approach in ensuring that practice staff are fully versed in the Access Agreement gold standard principles.
Minimum Qualifications • High School Diploma or GED. • 3 years’ experience in medical billing, accounts receivable, insurance, or related duties. • Knowledge of CPT and ICD‑10, medical billing software, and basic math. • Light, accurate keyboarding skills; preferred score of 35 words per minute (wpm) or greater on the typing assessment. • Qualified candidates must be able to effectively communicate with all levels of the organization.
Benefits and Wellness NYU Langone Nevada provides a comprehensive benefits and wellness package including financial security benefits, a generous time‑off program, employee resource groups, and a holistic wellness program focused on physical, mental, nutritional, sleep, social, financial, and preventive care. The offerings support development, family, and retirement needs.
NYU Langone Nevada is an equal opportunity employer and is committed to inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration. We require applications to be completed online.
View Know Your Rights: Workplace discrimination is illegal.
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Job Responsibilities
Cross‑cover other areas in the office as assigned (Accounts Receivable/Denials, Customer Service, or Authorizations).
Perform billing tasks assigned by management including data entry, claim review, charge review, accounts receivable follow‑up, and 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 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 to determine actions needed to resolve unpaid or incorrectly paid claims and/or to authorize procedures in assigned work queues, using payer websites, billing system information, and training within expected timeframes.
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 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, and escalate issues to management as needed. Maintain confidentiality and coordinate functions with others.
Assist the professional billing staff within the CBO with difficult and escalated issues.
Assist the 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 the system to satisfy/edit payer requirements and re‑submit claims as needed.
Patient Experience & Access
Serve as NYU Langone Health Faculty Group Practice Brand Ambassador by upholding the NYULH Mission, vision, and values and promoting excellence in the patient experience.
Drive 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).
Greet patients warmly and professionally, stating name and role, and clearly communicate each step of the care/interaction as appropriate.
Work collaboratively with colleagues and site management to ensure a positive experience and timely resolution for all patient interactions.
Proactively anticipate patient needs, participate in service recovery by applying the LEARN model (Listen, Empathize, Apologize, Resolve, Notify), and escalates to leadership as appropriate.
Share ideas or observed areas of opportunity to improve patient experience and patient access with appropriate leadership.
Partner with Patient Access Center and Central Billing Office team members to support collaboration and promote a positive patient experience.
Take a proactive approach in ensuring that practice staff are fully versed in the Access Agreement gold standard principles.
Minimum Qualifications • High School Diploma or GED. • 3 years’ experience in medical billing, accounts receivable, insurance, or related duties. • Knowledge of CPT and ICD‑10, medical billing software, and basic math. • Light, accurate keyboarding skills; preferred score of 35 words per minute (wpm) or greater on the typing assessment. • Qualified candidates must be able to effectively communicate with all levels of the organization.
Benefits and Wellness NYU Langone Nevada provides a comprehensive benefits and wellness package including financial security benefits, a generous time‑off program, employee resource groups, and a holistic wellness program focused on physical, mental, nutritional, sleep, social, financial, and preventive care. The offerings support development, family, and retirement needs.
NYU Langone Nevada is an equal opportunity employer and is committed to inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration. We require applications to be completed online.
View Know Your Rights: Workplace discrimination is illegal.
#J-18808-Ljbffr