Hospital Care Investigator (000494)

Equiliem; New York (NY); On-site; USD 50,000 - 65,000; Full time

Job summary

A leading healthcare staffing company is seeking a Billing Specialist to manage billing processes and ensure accurate claims submission. The role involves collaborating with various departments, handling insurance inquiries, and maintaining patient account accuracy. The ideal candidate will have strong customer service skills and relevant experience in billing and collections. This position offers a structured schedule with a comprehensive benefits package.

Benefits

Medical Insurance

Vision & Dental Insurance

Life Insurance

401K

Commuter Benefits

Employee Discounts & Rewards

Payroll Payment Options

Qualifications

• 4 years experience in interviewing, investigation, or related field.
• High School diploma or equivalent required.

Responsibilities

• Manage front-end and back-end billing processes.
• Follow up with insurance companies for authorizations.
• Perform billing activities and process rejections.

Skills

Customer Service

Collaboration

Documentation

Education

Baccalaureate Degree

High School Diploma

Job description

A member of the revenue cycle process, billers are responsible for reviewing accounts, correcting claim edits, preparing and completing claims for submission to payers, posting all types of payments, and updating patient accounting systems. They will perform related functions in support of the Patient Financial Services operations and other duties, as assigned. The identification of essential functions below is not intended to be an exhaustive list of all duties that may be assigned to this position, nor does it restrict the duties which may be assigned to the position within the revenue cycle process.

Responsibilities include:

1. Follow up with insurance and financial counseling.
2. Manage front-end and back-end billing processes.
3. Contact insurance companies and obtain insurance plan authorizations.
4. Perform billing activities.

Education Requirements:

Baccalaureate Degree from an accredited college or university; or a High School diploma or its educational equivalent approved by the State Department of Education or a recognized accrediting organization, and four (4) years of full-time experience in interviewing, investigation, or a related field, such as credit and collection follow-up or bookkeeping; or education and/or experience which is equivalent to the above. College credits may be substituted for experience at a rate of thirty (30) semester credits per one (1) year of experience. All candidates must have at least a High School diploma or its educational equivalent.

Knowledge, Skills, and Abilities:

• Complete both paper and electronic claims promptly.
• Use computer systems effectively.
• Document patient information clearly and thoroughly.
• Collaborate with other departments to complete billing on accounts.
• Process rejections, denials, and correspondence timely.
• Handle pre-authorizations, document responses, and follow up as needed.
• Audit patient accounts for accuracy.
• Apply adjustments as necessary.
• Provide customer service for billing inquiries, ensuring conversations are well documented.
• Process statements, enter data into databases, and review past-due bills, following up on overdue accounts.
• Generate Patient Balance Aging and Insurance Aging reports, and follow up with patients and insurers accordingly.
• Arrange payment schedules with patients.
• Escalate accounts to supervisors when necessary.
• Attend training sessions to perform duties effectively.
• Perform other duties as assigned by the Manager or Supervisor.

Schedule:

Monday to Friday, 9 am to 5 pm, no weekends or holidays. Includes a 1-hour lunch break.

Position Reason:

Vacancy

Company Overview:

Equiliem Healthcare specializes in staffing clinical, non-clinical, and allied healthcare personnel across various disciplines and specialties. Our projects range from short-term to long-term, local, and travel assignments. Recognized as a certified small business enterprise, we hold accreditation from the Joint Commission and have been awarded Best in Staffing for four consecutive years by our employees and clients.

Benefits:

Our comprehensive benefits package includes:

• Medical Insurance
• Vision & Dental Insurance
• Life Insurance
• 401K
• Commuter Benefits
• Employee Discounts & Rewards
• Payroll Payment Options