Business Office Associate-Denial and Appeals

Job Description

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 comprehensive 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. At NYU Langone Health, equity, diversity, and inclusion are fundamental values. We strive to be a place where our exceptionally talented faculty, staff, and students of all identities can thrive. We embrace diversity, inclusion, and individual skills, ideas, and knowledge. For more information, go to nyulangone.org, and interact with us on LinkedIn, Glassdoor, Indeed, Facebook, Twitter, YouTube and Instagram.

Position Summary :

We have an exciting opportunity to join our team as a Business Office Associate-Denial and Appeals.

In this role, the successful candidate under the general supervision of the Manager of Operations and Analytics for Denials and Appeals, the Denial and Appeals Coordinator is responsible for preparation and / or timely submission of appeals and medical records to third party payers for appropriate reimbursement. Assists the Denials and Appeals Analysts in updating of internal denial tracking tool and Epic notes. Escalates trends and issues to management for resolution.

Job Responsibilities :

• Reviews Medical Necessity and DRG work queues in Epic and identifies new denials received.
• Prepares new appeals and complete medical records for timely mailing to Insurance Payors or agencies acting on behalf of the Insurance Payors.
• Coordinates with appropriate Revenue Cycle departments to request medical records and denial letters as needed.
• Communicates with Insurance Payers or agencies acting on behalf of the Insurance Payors via email, fax and / or telephone to ensure timely review / resolution of denials / appeals.
• Researches and ensures appropriate denial rationale letters are in OnBase for Appeal Writers
• Updates Internal Tracker with specific denial codes and notes in EPIC in comments section
• Review accounts in Epic to ensure reimbursement is received for overturned appeals.
• Maintains mailing supply inventory, verifies inventory levels, and notifies manager as to replacement needs or places orders as appropriate.
• Creates and maintains mailing labels for specific payors.
• Organizes and updates electronic appeal letter library.
• Establishes a working relationship with Case Management, Health Information Management, Clinical Documentation Improvement,and other Revenue Cycle Departments.
• Supports Denial and Appeals team with additional tasks as needed
• Participates in enterprise and hospital-based meetings as needed.

Minimum Qualifications :

To qualify you must have a Associated Degree or equivalent

Relevant work experience and acute care hospital experience in Revenue Cycle or Revenue Cycle Operations

Proficiency in Microsoft applications, EPIC, and relevant hospital based clinical computer systems

Evidence of applying critical thinking skills to achieve established goals

Ability and willingness to work a flexible schedule to ensure compliance with deadlines

Demonstrates the ability to handle multiple assignments and carry out work independently with minimal supervision

Capacity to work collaboratively in a team environment

Excellent Organizational Skills

Ability to work under pressure and required timeframes and deliver accurate and timely results

Excellent verbal and written communication skills

One to three years hospital billing experience, receptionist duties, or equivalent demonstrated ability.

One to three years acute care hospital experience in Revenue Cycle or Revenue Cycle operations.

Preferred Qualifications :

Proficiency in the EPIC application with a focus on the various Revenue Cycle modules.

Full understanding of the Denial and Appeal Process

Qualified candidates must be able to effectively communicate with all levels of the organization.

NYU Langone Health 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 Health 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 Health's EEO policies, please click here. Please click here to view the Federal "EEO is the law" poster or visit for more information.

NYU Langone Health provides a salary range to comply with the New York state Law on Salary Transparency in Job Advertisements. The salary range for the role is $41,977.18 - $57,000.00 Annually. Actual salaries depend on a variety of factors, including experience, specialty, education, and hospital need. The salary range or contractual rate listed does not include bonuses / incentive, differential pay or other forms of compensation or benefits.

To view the Pay Transparency Notice, please click here

Salary : $41,977 - $57,000