Hospital Billing & Benefit Investigator

NYC Health + Hospitals; New York (NY); On-site; USD 45,000 - 65,000; Full time

Job summary

NYC Health + Hospitals seeks a Billing Investigator to determine eligibility for medical assistance programs and assess patients' ability to pay; you will verify and update demographic and insurance data, perform billings and collections, and help maximize hospital revenue.

You will coordinate with Medicaid/Medicare, social services, and outside agencies, and handle third‑party billing forms, ensuring accuracy and timely follow‑ups.

Qualifications

• A baccalaureate degree from an accredited college or university; or
• An associate’s degree from an accredited college or university; and completion of an accredited certificate program in medical billing; or
• A four‑year high school diploma or its educational equivalent; and completion of an accredited certificate program in medical billing; and two (2) years of full‑time experience, such as interviewing, investigation, or related field.
• A four‑year high school diploma or its educational equivalent; and four (4) years of full‑time experience, as described in #3 above, at least two years in interviewing, investigations, or related field such as credit and collection follow‑up or bookkeeping; or
• Education and/or experience which is equivalent to (1)-(4) above; college credits may be substituted for experience with the appropriate certificate in medical billing or two years experience in interviewing/investigations.

Responsibilities

• Informs patients of healthcare rates and conducts in-depth interviews to determine ability to pay.
• Contacts outside agencies, insurance carriers, and employers for revenue sources.
• Acts as liaison with social services and home care agencies.
• Refer patients to Medicaid, Social Security and other programs for benefits.
• Facilitate processing of applications for third‑party benefits like Medicaid and Medicare.
• Review charts to obtain information for third‑party billing forms.
• Review patient accounts to ensure proper billing and update systems accordingly.
• Respond to inquiries from patients and payers and resolve billing disputes.
• Follow up on collections to maximize revenue.

Skills

Interviewing

Investigations

Customer service

Education

Bachelor's degree

Associate's degree + medical billing certificate

High school diploma + medical billing certificate

High school diploma + 2 years investigating/credit collection experience

High school diploma + 4 years investigating/related experience

Job description

NYC Health + Hospitals seeks a Billing Investigator to determine eligibility for medical assistance programs and assess patients' ability to pay; you will verify and update demographic and insurance data, perform billings and collections, and help maximize hospital revenue.

You will coordinate with Medicaid/Medicare, social services, and outside agencies, and handle third‑party billing forms, ensuring accuracy and timely follow‑ups.