NYU Langone is one of the nation's premier academic medical centers that includes five hospitals (Tisch Hospital, Rusk Rehabilitation, Hospital for Joint Diseases, Hassenfeld Children's Hospital of New York, and NYU Lutheran Medical Center) and more than 200 ambulatory locations across the New York metropolitan area. It also includes NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. Our trifold mission to serve, teach, and discover is achieved daily through an integrated academic culture devoted to excellence in patient care, education, and research. Learn more about NYU Langone.
We have an exciting opportunity to join our team as a FGP Senior Billing Rep (35).
In this role, the successful candidate Under the general direction of the FGP Radiology Insurance Verification/Pre-cert Manager, the position is responsible for obtaining and documenting insurance verification and pre-authorizations and pre-certifications prior to patient appointments and facilitating patient administrative needs. They communicate directly with patients and referring physicians to obtain appropriate insurance and clinical information required to obtain an authorization from the appropriate utilization management company. They are required to contact patients directly and reschedule the exam if the authorization is not obtained prior to appointment time.
Maintains cooperative and professional relationships with physicians, nurses and office staff. Has a positive relationship with colleagues. Cooperates with supervisor and other members of the team. Works well with others. All other related duties as required.
Reschedules all patients for whom insurance verification/authorization information has not been obtained prior to the patient's appointment. Effectively obtains all necessary pre-registration information (i.e. demographic and insurance information) from patients, caregivers and other staff members. Answers phones and screens incoming calls. Accurately takes messages, provides information and/or redirects callers to the appropriate department in a timely manner. Sends timely requests to referring physicians for authorization when NYULMC Radiology cannot obtain. Communicates authorization cases denied for medical necessity or requiring peer-to-peer review to the referring physician for resolution. Documents authorization in EPIC according to defined protocol. Properly refers patients to the Financial Counselor as needed. Answers incoming calls from patients and referring physician offices regarding authorization status and pending requirements.
Principal Responsibilities: Maintains patient schedule and related insurance verification/pre-authorization information. Utilizes applicable computer systems to obtain insurance verification/pre-authorization for scheduled patients. Effectively communicates scheduled services and provides information to patients, caregivers, and other staff members as necessary.
High School Diploma and 2 years' relevant experience or the equivalent combination of education and experience. Must include prior medical scheduling experience and knowledge of insurance companies admission procedures and policies to complete insurance verification and pre-authorization requirements and knowledge of medical terminology for multiple subspecialties. Proficiency with intermediate to advanced scheduling software, word processing, spreadsheet, database applications and Internet-based healthcare applications/websites. Moderate, accurate keyboarding skills. Highly detail-oriented with strong organizational, communication and customer services skills. Ability to multitask and prioritize in a fast-paced environment.
Bachelor's Degree and three years practice support and scheduling experience in a high-volume healthcare environment.
Qualified candidates must be able to effectively communicate with all levels of the organization.
NYU Langone 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.
NYU Langone Medical Center 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. We require applications to be completed online. If you wish to view NYU Langone Medical Center's EEO policies, please click here. Please click here to view the Federal 'EEO is the law' poster or visit https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm for more information. To view the Pay Transparency Notice, please click here.
NYU Langone Medical Center, a world-class patient-centered integrated academic medical center, is one of the nation's premier centers for excellence in clinical care, biomedical research, and medical education. Located in the heart of Manhattan, NYU Langone is composed of four hospitals – Tisch Hospital, its flagship acute care facility; Rusk Rehabilitation; the Hospital for Joint Diseases, one of... only five hospitals in the nation dedicated to orthopaedics and rheumatology; and Hassenfeld Children's Hospital, a comprehensive pediatric hospital supporting a full array of children's health services across the medical center – plus the NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. The medical center's tri-fold mission to serve, teach, and discover is achieved 365 days a year through the seamless integration of a culture devoted to excellence in patient care, education and research. For more information, go to www.NYULMC.org.