Billing Coordinator II (FGP) - Manhattan, Child Adolescent Psychiatry

Billing Coordinator II (FGP) - Manhattan, Child Adolescent Psychiatry

Finance/Accounting/Billing

New York, NY • Full-Time/Regular

NYU Grossman School of Medicine is one of the nation's top-ranked medical schools. For 175 years, NYU Grossman School of Medicine has trained thousands of physicians and scientists who have helped to shape the course of medical history and enrich the lives of countless people. An integral part of NYU Langone Health, the Grossman School of Medicine at its core is committed to improving the human condition through medical education, scientific research, and direct patient care. At NYU Langone Health, equity and inclusion are fundamental values. We strive to be a place where our exceptionally talented faculty, staff, and students of all identities can thrive. We embrace inclusion and individual skills, ideas, and knowledge.

Position Summary: We have an exciting opportunity to join our team as a Billing Coordinator II (FGP) - Manhattan, Child Adolescent Psychiatry. In this role, the successful candidate will become a key member of the NYU Langone Health Faculty Group Practice Central Billing Offices (FGP CBO). Coordinate all aspects of coding review, claim submission, charge reconciliation and follow-up on claims denied for coding-related reasons for various specialties and providers. Provide coding, financial and/or operational reports, and provide feedback to providers to improve documentation to maximize revenue and reduce denials. Review and train practices on local and national coding and reimbursement policies including payer coding guidelines. Work with patients and guarantors to clarify financial responsibilities as needed.

Job Responsibilities:

• Take initiative to teach and share new information and provide constructive feedback. Communicate delays and workqueue issues to management daily.
• Lead and collaborate with practice personnel and administration to implement change to practice operations where necessary, to improve accuracy of information and enhance revenue.
• Ensure timely and accurate collection, preparation, and verification of billing information submitted in billing system. Review billing collection and denial reports and recommend changes on how to improve issues.
• Serve as a liaison to coding vendor for questions, data requests, and other inquiries. Review charge encounter forms for complete CPT code, ICD-10 code, and other required billing information on a daily basis.
• Compare coding to notes/documentation and communicate with providers to clarify errors, correct coding and prepare appeals and reconsideration requests. Appeal complex denials through review of payer policies, coding, contracts, and medical records. Utilize subject matter experts as needed.
• Analyze/audit notes and ensure the appropriate codes are charged in order to maintain billing compliance and prevent denials.
• Staff who possess coding certification at the time of hire or who obtain coding certification while employed by NYU must maintain active status of certification.

Patient Experience and Access

• Serves as NYU Langone Health Faculty Group Practice Brand Ambassador by upholding the NYULH Mission, vision and values and promoting excellence in the patient experience, during every encounter.
• Drives 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)
• Greets patients warmly and professionally, stating name and role, and clearly communicates each step of the care/interaction as appropriate
• Works collaboratively with colleagues and site management to ensure a positive experience and timely resolution for all patient interactions and inquiries whether in person, by phone or via electronic messaging.
• Proactively anticipates patient needs, and participates in service recovery by applying the LEARN model (Listen, Empathize, Apologize, Resolve, Notify), and escalates to leadership as appropriate.
• Shares ideas or any observed areas of opportunity, to improve patient experience and patient access, with appropriate leadership. (i.e. ways to optimize provider schedules, how to minimize delays, increase employee engagement, etc.)
• Partners with Patient Access Center and Central Billing Office team members to support collaboration and promote a positive patient experience.
• Takes a proactive approach in ensuring that practice staff are fully versed in the Access Agreement gold standard principles.

Professional and Hospital Billing Responsibilities

• Collects and applies payments for self-pay, deductibles, co-payments and co-insurance into the appropriate system (s).
• Monitors patient accounts to proactively ensure there aren’t any surprise issues that may impact patient experience, financial performance or clinical schedules.
• Manages relationship between multiple stakeholders including the IBH administrative team, Fink Center administrative team and Child Study Center leads.
• Serves as the point person for issues related to patient claims and scheduling for the IBH and Consult Liaison services.
• Performs billing tasks assigned by management which may include data entry, claim review, charge review, accounts receivable follow-up, or other related responsibilities.
• Performs daily tasks in assigned work queues and according to manager assignments.
• Provides input on system edits, processes, policies, and billing procedures to ensure maximization of revenues.
• Reviews reports to identify revenue opportunities and unpaid claims. Contact insurance companies to follow up on claims as necessary.
• Adheres to general practices and FGP guidelines on compliance issues and patient confidentiality.
• Communicates with providers, patients, coders, or other responsible persons to ensure that claims are correctly processed by third party payers.
• Cross-covers other areas in the office as assigned by management, including accounts receivable/denials, customer service, authorizations, patient scheduling, Epic template build etc.
• Identifies payer, provider credentialing, and/or coding issues and address them with management.
• Follows workflows provided in training classes and request additional training as needed.
• Utilizes Central Billing Office (CBO) pathways as a guide for determining actions needed to resolve unpaid or incorrectly paid claims and/or for authorizing procedures in assigned work queue(s) using payer websites, billing system information and training within expected timeframe.
• Assists the professional and hospital billing staff within the CBO with difficult and escalated issues.
• Reads and apply policies and procedures to make appropriate decisions and escalates issues to management as needed.

Patient Experience & Access Responsibilities

• Responds to multi-channel inquiries from patients, physicians, employees, and other callers regarding appointments, referrals, provider messages, and services in accordance with established NYU Langone Faculty Group Practice (FGP) guidelines.
• Supports the scheduling process by reviewing providers insurance participation status and coverage of patients insurance benefits. Completes the insurance pre-authorization process to support visit scheduling.
• Manages conversations with a high level of sensitivity and use good judgment when determining and documenting appropriate disposition.

Minimum Qualifications:

• Bachelor's Degree with a minimum of 3+ years of relevant work experience or equivalent combination or training and relevant work experience, required.
• Ability to multi-task and prioritize.
• Good communication, interpersonal, and computer skills.
• Ability to develop and maintain effective working relationships with staff and patients.
• Detail oriented with high level of accuracy for reviewing charge batch submissions, analyzing and correcting coding denials, preparing, and presenting analyses.
• Stays up to date with industry requirements.
• Knowledge of medical terminology required.
• Familiar with standard office equipment.

Qualified candidates must be able to effectively communicate with all levels of the organization. NYU Grossman 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. At NYU Langone Health, we are committed to supporting our workforce and their loved ones with a comprehensive benefits and wellness package. Our offerings provide a robust support system for any stage of life, whether it's developing your career, starting a family, or saving for retirement. The support employees receive goes beyond a standard benefit offering, where employees have access to financial security benefits, a generous time-off program and employee resources groups for peer support. Additionally, all employees have access to our holistic employee wellness program, which focuses on seven key areas of well-being: physical, mental, nutritional, sleep, social, financial, and preventive care. The benefits and wellness package is designed to allow you to focus on what truly matters. Join us and experience the extensive resources and services designed to enhance your overall quality of life for you and your family. NYU Grossman School of Medicine is an equal opportunity employer and committed to inclusion in all