Billing Coordinator; Level III FGP), Manhattan, Plastic Surgery

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We have an exciting opportunity to join our team as a Billing Coordinator(Level III) - (FGP), Manhattan, Plastic Surgery.

In this role, the successful candidate 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.

• Monitor reports and assigned work queues, ensuring coding, charge submission and accounts receivable follow-up is occurring on a timely basis.
• Perform charge reconciliation to validate all revenue is captured.
• Review unbilled charge reports and follow up with physicians and/or practice management for unbilled services.
• Review claims denied for coding errors, bundling, medical necessity, and/or other related reasons. Correct coding errors, drafts appeal letters based on physician documentation and coding guidelines, submit supplemental claim information to insurance companies and follow‑up on appeals as necessary.
• Identify coding or documentation issues and suggest improvements to physicians. Escalate issues as needed to practice and FGP Leadership.
• Communicate with, and train, coding and A/R vendors as it relates to various coding, reimbursements, billing processes and collections.
• Work with front‑end staff to ensure patient insurance information and benefits are verified accurately and timely. Act as a resource to front end practice staff to identify gaps in financial clearance processes.
• Review and respond to practice, physician, and patient inquiries following CBO guidelines, payer rules, compliance regulations and related rules.
• Serve as resource to physicians, staff, and management regarding local and national coding and reimbursement policies.
• Collaborate with the corporate Revenue Integrity Analysts to understand CPT and ICD‑10 guidelines, payer policy and procedure manuals, updates, and CMS publications to ensure practices are compliant with current policies and procedures. Train physicians, other staff, and management, as needed.
• Adhere to general practice and FGP guidelines on compliance issues and patient confidentiality.
• Meet CBO quality and productivity targets.
• Review practice Action Plans and/or reports on a timely basis. Analyze issues to identify trends in denial rates to focus improvement initiatives on, and charges that requires action.
• May act as a financial counselor to patients who require assistance understanding their…