NYU Langone Health is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education. It comprises more than 200 locations throughout the New York area, including five inpatient locations, a children’s hospital, three emergency rooms and a level 1 trauma center. Also part of NYU Langone Health is the Laura and Isaac Perlmutter Cancer Center, a National Cancer Institute designated cancer center, and NYU Grossman School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. For more information, go to nyulangone.org, and interact with us on Facebook, Twitter, YouTube and Instagram.

POSITION SUMMARY: We have an exciting opportunity to join our team as a Assistant Director-Financial Clearance. In this role, the successful candidate Responsible for various projects geared towards increasing cash flow, managing growth, improving efficiency/quality, and optimizing workflows. The Assistant Director will be an integral part of the management team of the Billing Office managing the leaders of Revenue Cycle in functional areas which may include customer service, accounts receivable, self-pay, authorizations, Training/Quality, and/or operations. The candidate will develop project plans, gather/analyze data, and make recommendations to leadership. The Assistant Director will work closely with practice managers/administrators, account managers, revenue cycle staff, vendors, managed care, credentialing, and medical center IT teams. The ideal candidate must understand complete revenue management workflows.

JOB RESPONSIBILITIES:

• Monitor reports and work queues, ensuring charge submission and accounts receivable follow-up is occurring on a timely basis.
• Identify issues and suggest improvements and available tools to physicians and admin support staff to address issues. Escalate issues as needed to practice and FGP Leadership.
• Interact with vendors as it relates to billing 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 clearance processes.
• Review and respond to practice, physician, and patient inquiries following CBO guidelines.
• Serve as resource to physicians, staff, and management regarding local and national coding and reimbursement policies. Educate physicians, staff, and management on new policies and changes to existing policies.
• Collaborate with coders to understand CPT and ICD-10 manuals, payer policy and procedure manuals, updates, and CMS publications to ensure practices are compliant with current policies and procedures.
• Adhere to general practice and FGP guidelines on compliance issues and patient confidentiality.
• Review unbilled charge reports and follow up with physicians and/or practice management for unbilled services.
• Ensure staff 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.
• Take initiative to teach and share new information and provide constructive feedback; Communicate delays and work queue issues to management daily.
• Work with practice operations to implement changes to improve revenue where necessary.
• Ensure timely and accurate collection, preparation, and verification of billing information submitted to the outsourced billing service. Review billing collection and denial reports from the vendor and identify trends and recommend changes on how to improve issues.
• Serve as a liaison to the outside billing for questions, data request, and other inquiries. Review charge encounter forms for complete CPT code, ICD-10 code, and other required billing information on a daily basis.
• Analyze/audit notes and ensure the appropriate codes are charged in order to maintain billing compliance and prevent denials.
• Identify denial trends and train staff accordingly to avoid in the future, emphasizing improvement of accurate charge capture. Develop supporting training documentation as needed with FGP management.
• Lead and collaborate with practice personnel and administration to implement change to practice operations where necessary.
• Serve as primary resource to physicians, staff, and management regarding local and national coding and reimbursement policies.
• Delegate, coordinate, and evaluate the charge submission and/or accounts receivable work of Billing Representatives or Billing coordinators in multiple groups. Communicate responsibilities and expected performance to staff.
• Determine and establish the explanation to complex claims, issues, and questions not covered by specific instructions or common practice.
• Review outstanding accounts receivable to maintain minimal level of open accounts.
• Compile statistical data as requested and reports data monthly to appropriate parties. Prepare reports and analyses to assist in identification of cash flow variances, physician referral patterns, physician volume, and any other issues identified by Management.
• Meet or exceed internal standards for accuracy and timeliness in charge documentation preparation and submission.
• Directly supervise billing employees, establish priorities, assign work, and follow up to ensure assignments are complete. Select, orient, and evaluate staff. Provide initial and ongoing guidance. Resolve employee issues and address procedure and performance related issues.
• Train staff and clearly explain proper work procedures and methods and office policy

MINIMUM QUALIFICATIONS: To qualify you must have a Bachelors Degree with a minimum of 5-7 years of relevant work experience or equivalent combination or training and relevant work experience. Ability to handle multiple tasks at once; good communication, interpersonal, and computer skills. Arrive on time for work and meetings. Ability to develop and maintain effective working relationships with staff and patients. High level of accuracy for reviewing charge batch submissions, preparing and presenting analyses, and in staff education. Maintain current insurance regulatory policies and requirements relevant to the specialty. Knowledge of medical terminology required. Familiar with standard office equipment.

NYU Langone Florida 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.

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Required Skills Required Experience