Medical Billing & Eligibility Investigator

NYC Health + Hospitals; New York (NY); On-site; USD 52,000 - 76,000; Full time

Job summary

Harlem Hospital Center in New York is seeking a Billing and Collections Specialist to determine eligibility for medical assistance programs and to manage billing for hospital charges.

Under supervision, you will verify demographic and insurance data, code information, bill third-party claims, pursue revenue, and act as a liaison with patients and insurers. The role demands strong communication and attention to detail in a high-volume hospital setting.

Qualifications

• Bachelor’s degree or higher from an accredited college or university.
• Associate’s degree plus an accredited medical billing certificate.
• High school diploma plus a medical billing certificate and 2 years related experience.
• Four-year high school diploma and 4 years related experience, with 2 in interviewing/investigation or billing.
• Equivalent combinations of education and experience with required certificate in medical billing.

Responsibilities

• Determine patients' ability to pay and inform them of hospital rates.
• Contact outside agencies and insurers for revenue information.
• Refer patients to Medicaid, Medicare, or other benefits as needed.
• Process enrollment for third-party billing and maximize revenue.
• Review charts and code information for billing and claims.
• Verify and update patient data in the system.
• Handle complex inquiries from patients and payers and resolve disputes.
• Follow up on collections to maximize revenue.

Skills

Interviewing

Investigation

Customer service

Billing knowledge

Medical billing

Education

Bachelor's degree

Associate’s degree + medical billing certificate

High school diploma + medical billing certificate

Two years experience in interviewing/investigation or related field

Four years experience incl. two in interviewing/investigations

Job description

Harlem Hospital Center in New York is seeking a Billing and Collections Specialist to determine eligibility for medical assistance programs and to manage billing for hospital charges.

Under supervision, you will verify demographic and insurance data, code information, bill third-party claims, pursue revenue, and act as a liaison with patients and insurers. The role demands strong communication and attention to detail in a high-volume hospital setting.