Balance Billing Coordinator - 1199 SEIU Funds : Job Details
Balance Billing Coordinator
1199 SEIU FundsJob Location : New York,NY, USA
Posted on :
2025-08-09T01:02:43Z
Job Description :
ResponsibilitiesNegotiate and resolve large volume of balance billing inquiries, negotiate fees and discounts for members with non-participating providers to reduce out of pocket expenses; Communicate via telephone and written correspondence with providers, members, attorneys, or collection agencies to resolve balance billing/fee negotiation inquiries to completion; handle large call volume in reference to balance billing inquiries; Analyze received correspondence; verify member eligibility, claim history and coordination of benefits; Review claims to determine if appropriate action was taken; follow up with Claims and Recovery Units to initiate adjustments and recover monies; Identify billing anomalies and alert the Fraud and Abuse Department to reduce fraudulent billing practices; Triage balance billing/fee negotiation inquiries and ensure all documents are processed in a timely and efficient manner; Research provider contracts and lease network reports to ensure providers are not breaching contracts by referring members out of network; Educate members and providers with out of network fees, out of pocket expenses and benefits of using the Funds network; Perform additional duties and projects as assigned by management. QualificationsHigh School Diploma or GED required, some college or college degree preferred; Minimum two (2) years experience processing medical professional and facility hospital claims preferred; Experience negotiating bills and payments for managed care plans preferred; Knowledge of provider contracts and collections processes preferred; Excellent knowledge of health claims, eligibility rules, Coordination of Benefits (COB), 1199SEIU Benefit and Pension Fund and Retiree Benefits; Knowledge of Current Procedural Terminology (CPT) codes, and International Classification of Diseases (ICD-10) codes preferred; Knowledge of health claims processing and benefit administration systems (QNXT and Vitech V3) preferred; Familiar with provider databases, web-based applications and call tracking systems (i.e. Cactus, IObserver, BeneFAQs, Member and Provider Portal); Strong analytical and problem solving skills; able to work well independently and in a team oriented environment; Basic skill level in Word, Excel and Access required; Outstanding customer service skills; ability to maintain a pleasant attitude and provide excellent service to members and providers; Excellent oral and written communication skills; must be able to communicate clearly with members, staff and external partners; Must be able to work well under pressure, prioritize work with tight schedules and target dates in a high volume environment required; Detail oriented with demonstrated organizational skills; ability to multi-task and follow up. #J-18808-Ljbffr
Apply Now!
Similar Jobs (
0)