Billing Representative

Position Summary We have an exciting opportunity to join our team as a Billing Representative III (A/R) - Florida. This role requires advanced billing and financial clearance functions including claims management, complex denial resolution, insurance authorizations, precertifications, and patient cost estimates. It supports staff with escalated issues and participates in training and process improvement efforts. Job Responsibilities Perform billing tasks assigned by management such as 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 maximize 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 to determine actions needed to resolve unpaid or incorrectly paid claims and authorizing procedures in assigned workqueues using payer websites, billing system information, and training within expected timeframe. Review reports to identify revenue opportunities, unpaid claims, and delays in obtaining authorizations or 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 claims are correctly processed by third‑party payers. Follow operational policies, procedures, and regulatory requirements. Participate in workgroups and meetings; attend all required training classes; elevate issues to management; maintain confidentiality. Read and apply policies and procedures to make appropriate decisions. Coordinate functions and work cooperatively with others. 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. Other related duties as assigned. Patient Experience and Access Drive consistency in every patient and colleague encounter by embodying the core principles of the Billing Department Service Strategy CARES. Greet patients warmly and professionally, stating name and role, and clearly communicate each step of the encounter. 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; elevate to leadership as appropriate. Share ideas or any observed areas of opportunity to improve patient experience and access with appropriate leadership. 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. Experience in medical billing, accounts receivable, insurance, or related duties; knowledge of CPT and ICD‑10; familiarity with medical billing software; English usage, grammar, and spelling; basic math. 3 years of experience in a similar role. Accurate keyboarding skills; preferred typing speed of 35 words per minute or greater. 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. Time‑management skills. 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. Benefits NYU Langone Florida provides a comprehensive benefits and wellness package, including financial security benefits, a generous time‑off program, employee resource groups, and a holistic wellness program focusing on physical, mental, nutritional, sleep, social, financial, and preventive health. Equal Opportunity Employer NYU Langone Florida 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. #J-18808-Ljbffr