Hospital Care Investigator

NYC Health + Hospitals; New York (NY); On-site; USD 53,000; Full time

Job summary

NYC Health + Hospitals is seeking a Hospital Care Investigator to conduct investigations and determine eligibility for medical assistance in a healthcare setting. The role involves billing, collections, and liaising with various agencies to maximize revenue. Ideal candidates will have relevant educational qualifications and experience in interviewing or investigations.

Benefits

Comprehensive Health Benefits

Retirement Savings and Pension Plans

Loan Forgiveness Programs

Paid Holidays and Vacation

College tuition discounts

Professional development opportunities

Qualifications

• A baccalaureate degree from an accredited college or university.
• Two years of experience in interviewing or investigation.
• Completion of an accredited certificate program in medical billing.

Responsibilities

• Conduct investigations to determine eligibility for medical assistance.
• Perform billing and collections functions to maximize revenue.
• Act as a liaison with social services and outside agencies.

Skills

Interviewing

Investigation

Customer Service

Education

Baccalaureate degree

Associate's degree with medical billing certificate

High school diploma with medical billing certificate

Job description

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NYC Health + Hospitals provided pay range

This range is provided by NYC Health + Hospitals. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$52,128.00/yr - $52,128.00/yr

Marketing Statement

NYC Health + Hospitals/Bellevue is America’s oldest public hospital, established in 1736. Affiliated with the NYU School of Medicine, the 844-bed hospital is a major referral center for highly complex cases, with its 6,000 employees including highly skilled, interdisciplinary clinical staff. It sees more than 110,000 emergency room visits and 500,000 outpatient visits annually. Bellevue is an academic medical institution of international renown. We have served as an incubator for major innovations in public health, medical science, and medical education. Bellevue is a Level I Trauma Center delivering around-the-clock care in adult, pediatric, psychiatric and pediatric psychiatric emergencies as well as in the nationally-designated categories of cardiology, neurology, toxicology, and neonatology. In addition to providing comprehensive inpatient and outpatient state-of-the-art care Bellevue is a city-wide medical specialty referral source. Bellevue’s clinical centers of excellence include: Emergency Medicine and Trauma Care; Cardiovascular Services; Designated Regional Perinatal Center and Neonatal Intensive Care Unit (ICU); Comprehensive Children’s Psychiatric Emergency Program; and Cancer Services.

At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.

Job Description

Purpose of Position:

Under direct supervision, conducts investigations in a health care setting to determine the eligibility of applicants for medical assistance payment programs or the ability of patients and their legally responsible relatives to pay for hospital or health care charges and takes the necessary actions to bill and collect for these services; explores alternative sources for payment for health care setting services rendered; codes, verifies and modifies demographic and insurance data obtained from source documents and enters such data into a computerized system; performs billings and collections functions in order to obtain maximization of health care setting’s revenue; all personnel perform related work.

Examples Of Typical Tasks

• 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.
  
  

Minimum 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 in interviewing, investigation, or a related field, such as credit and collection follow-up or bookkeeping, or as a customer service representative providing comprehensive customer service entailing the dispensing of information or listening to and resolving customer’s concerns, problems and complaints or troubleshooting; or
• 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 of which must have been in interviewing, investigations, or a related field such as credit and collection follow-up or bookkeeping; or
• Education and/or experience which is equivalent to (1), (2), (3) or (4) above. College education may be substituted for experience on the basis that thirty (30) semester credits are equivalent to one (1) year of experience and candidates must have completed an accredited certificate program in medical billing or have at least two years of full-time experience in interviewing, investigations, or a related field such as credit and collection follow-up or bookkeeping. In addition, all candidates must have at least a four-year high school diploma or its educational equivalent.
  
  

Department Preferences

How To Apply

If you wish to apply for this position, please apply online by clicking the "Apply for Job" button.

NYC Health and Hospitals offers a competitive benefits package that includes:

• Comprehensive Health Benefits for employees hired to work 20+ hrs. per week
• Retirement Savings and Pension Plans
• Loan Forgiveness Programs for eligible employees
• Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts
• College tuition discounts and professional development opportunities
• Multiple employee discounts programs

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Contract

Job function

• Job function

  Management and Manufacturing

• Industries

  Hospitals and Health Care

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