Billing Representative I (HB Auth) - Las Vegas, Nevada

Position Summary We have an exciting opportunity to join our team as a Billing Representative I. In this role, the successful candidate performs advanced billing and financial clearance functions including claims management, complex denial resolution, insurance authorizations, precertifications, and patient cost estimates. This role provides support to staff with escalated issues and participates in training and process improvement efforts. 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. Provide input on system edits, processes, policies, and billing procedures to ensure maximization of revenues. 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 a 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. Review reports to identify revenue opportunities, unpaid claims, delays in obtaining authorizations/financial clearance. Adhere to general practices and departmental 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. Work following operational policies and procedures, and regulatory requirements. 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. Assist other billing representatives with difficult and escalated issues. Assist department supervisor with special projects and staff training. Appeal complex denials through review of payer policies, coding, contracts, and medical records; utilize subject matter experts as needed. Cross cover other areas in the office as assigned by management including Accounts Receivable/Denials, Customer Service, or Authorizations. Perform other related duties as assigned. Patient Experience and Access Drive consistency in every patient and colleague encounter by embodying the core principles of our Billing Department 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 and inquiries, whether in person, by phone, or via electronic messaging. Proactively anticipate patient needs, and participate in service recovery by applying the LEARN model (Listen, Empathize, Apologize, Resolve, Notify) and escalating to leadership as appropriate. Share ideas or any observed areas of opportunity to improve patient experience and patient access with appropriate leadership (e.g., ways to optimize provider schedules, minimize delays, increase employee engagement, etc.). Partner with internal and external 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 required. Three years of experience in medical billing, accounts receivable, insurance, or related duties. Knowledge of CPT and ICD‑10, medical billing software, English usage, grammar and spelling, basic math, and light, accurate keyboarding skills. Preference for candidates who can type 35 words per minute (wpm) or greater on the typing assessment administered prior to onboarding. Personal Characteristics Strong verbal and written communication skills, with the ability to collaborate across departments. Strong critical thinking and effective listening skills. Professional demeanor and positive attitude required. Time Management Skills Required Ability to develop and maintain effective working relationships with peers, other staff, and leadership. Qualified candidates must be able to effectively communicate with all levels of the organization. NYU Langone Nevada is an equal opportunity employer and 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 NYU Langone Health