The Bureau of Revenue focuses on optimizing insurance billing and reimbursements for services provided to insured New Yorkers across Article 28 health specialty clinics, Article 36, and other care management service areas. The role supports the Patient Billing team with claim review, claim submission, follow-up, and collection activities.
The position works closely with the Assistant Director of Patient Billing to support billing operations, monitor claims activity, resolve denials, and help ensure accurate reimbursement from third-party payers.
Key duties include:
- Overseeing billing and collection activities within the unit
- Reviewing daily billing reports and escalating issues
- Tracking patient demographics and insurance updates with clinic teams
- Managing medical records requests for prior authorization and reimbursement support
- Reviewing claims for CPT, ICD-10, HCPCS, and modifier accuracy
- Monitoring EDI denials and clearinghouse acceptance/rejection reports
- Correcting rejected claims and re-batching them to third-party payers
- Monitoring aging accounts receivable reports
- Reporting billing trends and changes to leadership
The role also supports NYC Health Department programs and public service goals while contributing to efficient revenue cycle operations.
Preferred skills and qualifications include:
- Knowledge of medical terminology, eligibility, and third-party reimbursement
- Working knowledge of prior approvals through managed care payer portals
- Strong writing, speaking, and active listening skills
- Excellent problem-solving and critical thinking skills
- Knowledge of health insurance industry best practices
- Basic knowledge of Article 28/36 New York State billing requirements
- Working knowledge of Microsoft Teams, Excel, PowerPoint, and basic accounting principles
- Ability to work independently, collaborate with others, multitask, and function as a team player
Minimum qualifications include one of the following:
- A master's degree in business or public administration, financial management, or public health plus 2 years of relevant experience in employee benefits or health insurance
- A bachelor's degree plus 3 years of relevant experience
- Equivalent education and/or experience, with at least a bachelor's degree and 1 year of experience in group benefits or group health insurance
- Certified Employee Benefits Specialist certification may substitute for 1 year of experience
Benefits and perks include:
- Potential eligibility for federal/state loan forgiveness and repayment assistance programs
- Premium-free health insurance plan that may save employees over $10K annually
- Additional health, fitness, and financial benefits depending on union/benefit fund
- Public sector defined benefit pension plan
- Tax-deferred savings program
- Worksite Wellness Program
- Work-from-home flexibility of up to two days per week, depending on the position
- Greater job security associated with public sector employment
Location
New York, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
2 months ago