Health Insurance Biller, Bureau of Revenue
Core
Manage health insurance billing, claim review, submission, and collections for insured New Yorkers in Article 28/36 clinics and care management services.
Role type
Health Insurance Biller (Claims & Collections)
Builds
Accurate insurance claims and reimbursement reports for DOHMH service areas
Domain
Public Health Administration / Health Insurance Billing
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
Medical terminology, CPT/ICD-10/HCPCS coding, CMS guidelines, EDI denial monitoring, aging accounts receivable analysis, Microsoft Excel, prior authorization portals
Preferred skills
Article 28/36 NY State billing requirements, managed care payer portals, accounting principles, problem solving
Technologies
Microsoft Teams, Excel, PowerPoint, billing software, managed care payer portals
Responsibilities
Review and edit claims for accuracy, monitor EDI denials, manage medical records requests for prior authorization, track patient demographics and insurance info, analyze aging accounts receivable, report billing trends
Seniority
Mid-level individual contributor