Billing Specialist I

2 weeks ago

Boynton Beach, Florida, United States NYU Langone Full time

Position Overview:
We are seeking a dedicated Billing Specialist I to contribute to our revenue cycle operations.

In this role, you will be responsible for submitting claims under general supervision, following up on outstanding balances (whether from insurance or patients), rectifying discrepancies, entering claim data, and managing authorization and precertification requests with insurance providers. You will also address denied claims and submit appeals as necessary.

Key Responsibilities:

  • Assist in various office functions as directed by management, including Accounts Receivable, Denials, Customer Service, or Authorizations.
  • Execute billing tasks assigned by management, which may encompass data entry, claim assessment, charge evaluation, and accounts receivable follow-up.
  • Provide insights on system edits, processes, policies, and billing protocols to enhance revenue generation.
  • Manage daily responsibilities in designated work queues according to managerial assignments.
  • Identify issues related to payer, provider credentialing, or coding and communicate them to management.
  • Adhere to training workflows and seek additional training when necessary.
  • Utilize CBO Pathways to determine necessary actions for resolving unpaid or incorrectly compensated claims and authorizing procedures in assigned work queues, leveraging payer websites and billing system information.
  • Analyze reports to uncover revenue opportunities and outstanding claims.
  • Comply with general practices and guidelines regarding compliance and patient confidentiality.
  • Engage with providers, patients, coders, or other relevant parties to ensure accurate processing of claims by third-party payers.
  • Operate in accordance with organizational policies, procedures, and regulatory standards.
  • Participate in workgroups and meetings, attend required training sessions, escalate issues to management as needed, and maintain confidentiality.
  • Support the professional billing team in resolving complex issues.
  • Assist department supervisors with special projects and staff training initiatives.
  • Challenge complex denials by reviewing payer policies, coding, contracts, and medical records, utilizing subject matter experts as necessary.
  • Make necessary corrections in the system to meet payer requirements and resubmit claims as needed.

Patient Experience & Access:


• Act as a representative of NYU Langone Health Faculty Group Practice by embodying the organization’s mission, vision, and values while promoting excellence in patient interactions.
• Ensure consistency in every patient and colleague interaction by adhering to the core principles of our service strategy: Connect, Align, Respond, Ensure, and Sign.
• Welcome patients warmly and professionally, clearly stating your name and role, and effectively communicating each step of the interaction.
• Collaborate with colleagues and management to ensure a positive experience and timely resolution for all patient inquiries, whether in person, by phone, or electronically.
• Anticipate patient needs proactively and engage in service recovery by applying the LEARN model (Listen, Empathize, Apologize, Resolve, Notify), escalating issues to leadership as appropriate.
• Share insights or observed opportunities for enhancing patient experience and access with relevant leadership.
• Collaborate with the Patient Access Center and Central Billing Office team members to foster a positive patient experience.
• Ensure that practice staff are well-versed in the Access Agreement gold standard principles.

Minimum Qualifications:
To be considered, candidates must possess a High School Diploma or GED. Experience in medical billing, accounts receivable, insurance, or related fields is required. Knowledge of CPT and ICD10 coding, medical billing software, English grammar and spelling, and basic mathematics is essential. Proficiency in accurate keyboarding skills is necessary, with a requirement of at least 35 words per minute on the typing assessment prior to onboarding.

Qualified candidates must demonstrate effective communication skills across all organizational levels.

NYU Langone Florida 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. Applications must be submitted online.

If you wish to view NYU Langone Florida's EEO policies, please click here. Please click here to view the Federal "EEO is the law" poster or visit for more information.



Required Skills:

Required Experience:

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