Billing Representative II, Full Time, Days (8:30a-4:30p), AMG-Vascular Surgery, Morristown, NJ

Job Title

Responsible for accurate prior authorization and billing process. Maintains related documents, updates corresponding records and responsible for enrollment and billing queries. Collaborate with the billing service function to support electronic and technical operations. Handles complex enrollment or billing issues and reports to the manager with the relevant updates. Candidate will be responsible for coding vascular services, obtaining insurance pre-certifications, prior authorizations, and referrals for office visits, medical procedures, diagnostic testing and specialty services.

Principal Accountabilities

Authorization Initiation - Obtaining necessary documentation, submitting requests and following up on pending requests and tracking their status.

Review Medical Records- Analyze patient medical records, including diagnosis, treatments and procedures, to support authorization request.

Communicating with insurance providers, requesting additional information, handling denials and addressing any issues related to authorization, denials or delays.

Review and analyze denial letters, coordinate peer to peer reviews with physicians, prepare appeals and work to secure final authorization.

Maintaining accurate records of prior authorizations requests, approvals, denials, and peer to peer reviews.

Documenting all authorization requests, approvals and denials in patients' records (Referral- communications)

Confirm the patients' insurance policy covers proposed procedure.

Ensure compliance with payer policies and procedures to avoid denials.

Document all communication and authorization details in EPIC.

Communicate authorization status (denial-delays) to patients or medical staff.

Obtain referrals from outside providers when needed.

Assist billers with insurance appeals should a claim deny.

Actively maintain current knowledge of insurance guidelines and pre-certification requirements.

Answer billing- insurance questions for department team members.

Assist patients with inquiries or complaints.

Review and assign procedure and diagnostic codes for vascular surgery clinicians. To include hospital surgeries, consultations, progress notes and IR procedures.

Monitoring office visit work queue to forecast charge entry volume.

Review clinical office notes for vascular surgeons, to ensure documentation supports assigned CPT code.

Reconcile appointment sessions using EPIC and Scheduling to confirm all charges completed.

Assist billing team with inquiries as needed.

Qualifications

Required:

High School Diploma or equivalent.

Preferred:

Experience with insurance verification, referral processes, and prior authorizations.

Experience with Medicare, Medicaid, and commercial insurance.

Fluency in CPT and ICD-10 Coding and medical billing.

Knowledge of healthcare billing and reimbursement including industry standard billing rules.

Excellent verbal and written communication skills

Strong Organization Skills

Working knowledge of medical terminology and anatomy.

Proficiency in Microsoft Office, Exchange, and electronic billing system

About Us

Atlantic Medical Group is a physician-led and physician-governed organization that delivers the highest quality health care, at the right place, the right price, and the right time. We are a multispecialty physician group with more than 1,000 doctors, nurse practitioners and physician assistants at over 300 locations throughout northern and central New Jersey and northeast Pennsylvania. Our mission is to deliver exceptional care recognizing the unique needs of all those we serve. Our vision is to achieve the best outcomes with our patients at the center of the physician-led team, driven by service, innovation and continuous learning.

Our integrated network offers seamless access to Atlantic Health's entire health care continuum and our nationally and regionally ranked hospitals. In collaboration with Atlantic Health, several of our practices offer urgent care and walk-in services.

In addition to primary care physicians, the team includes specialists that care for patients in all aspects of their health from pediatrics to geriatrics and everything in between. We make health decisions easier for patients with enhanced access to referrals.

Atlantic Health offers a competitive and comprehensive Total Rewards package that supports the health, financial security, and well-being of all team members. Offerings vary based on role level (Team Member, Director, Executive). Below is a general summary, with role-specific enhancements highlighted: Team Member Benefits

Medical, Dental, Vision, Prescription Coverage (22.5 hours per week or above for full-time and part-time team members)

Life & AD&D Insurance.

Short-Term and Long-Term Disability (with options to supplement)

403(b) Retirement Plan: Employer match, additional non-elective contribution

PTO & Paid Sick Leave

Tuition Assistance, Advancement & Academic Advising

Parental, Adoption, Surrogacy Leave

Backup and On-Site Childcare

Well-Being Rewards

Employee Assistance Program (EAP)

Fertility Benefits, Healthy Pregnancy Program

Flexible Spending & Commuter Accounts

Pet, Home & Auto, Identity Theft and Legal Insurance

Note: In Compliance with the NJ Pay Transparency Act (effective Sunday, June 1, 2025), all job postings will include the hourly wage or salary (or a range), as well as this summary of benefits. Final compensation and benefit eligibility may vary by role and employment status and will be confirmed at the time of offer.

EEO STATEMENT

Atlantic Health, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and therefore abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment, on the basis of race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, citizenship status, disability, age, genetics, or veteran status.