Healthcare Billing & Collections Investigator

NYC Health + Hospitals; New York (NY); On-site; USD 42,000 - 70,000; Full time

Job summary

Lincoln Medical and Mental Health Center, part of NYC Health + Hospitals, seeks a billing and eligibility professional to support medical assistance applications, billing, and collections in a health care setting. Under supervision, you will verify data, code, and process third-party billing forms to maximize revenue.

The role requires a high school or higher with medical billing training or equivalent experience; responsibilities include interviewing patients, contacting insurers, and following

Qualifications

• Baccalaureate degree from an accredited college or university; or an associate degree with a medical billing certificate.
• Two years full-time experience in interviewing, investigation, or related field.
• High school diploma with medical billing certificate and two years experience.
• High school diploma with four years experience; at least two years in interviewing or investigations.
• Equivalency allowed: college credits or combination of education and experience.

Responsibilities

• Informs patient of health care setting rates; performs in-depth interviews with patients, families, relatives and friends in an office setting or the health care setting, during field investigations, and/or by telephone to determine patients’ and/or legally responsible relatives’ ability to pay for services rendered.
• Contacts outside agencies, organizations, insurance carriers and employers to obtain necessary information about potential sources of revenue.
• Acts as a liaison with social services and home care agencies.
• Refers patients to various health care setting departments and outside agencies, such as Medicaid, New York State Unemployment Insurance, Social Security and Public Assistance for possible benefits.
• Facilities processing of patients’ applications for third-party benefits, including but not limited to Medicaid and Medicare.
• Reviews and abstracts medical charts to obtain pertinent information for accurately coding and completing third- party billing forms, indicating treatment given, discharge diagnoses and overall patient information for computerization purposes.
• Reviews patient account records to ensure patients are properly billed; verifies and corrects patient bills and codes information for computerized system.
• Verifies accuracy of patient information stored in computer and codes changes and modifications, as necessary.
• Responds to complex inquiries from patients and third-party payers and resolves disputes concerning bills submitted for payment.
• Follows-up on collections to ensure maximization of revenue.

Education

Baccalaureate degree

Associate degree + medical billing certificate

High school diploma + medical billing certificate + 2 years experience

High school diploma + 4 years experience with 2 in interviewing/investigations

Education and/or experience equivalent

Job description

Lincoln Medical and Mental Health Center, part of NYC Health + Hospitals, seeks a billing and eligibility professional to support medical assistance applications, billing, and collections in a health care setting. Under supervision, you will verify data, code, and process third-party billing forms to maximize revenue.

The role requires a high school or higher with medical billing training or equivalent experience; responsibilities include interviewing patients, contacting insurers, and following