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Senior Hospital Care Investigator
2 months ago
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.
Work Shifts
8:00 A.M - 4:00 P.M
Job Description
Purpose:
A member of the revenue cycle process, Billers/AR follow-up are responsible for reviewing accounts, correcting claim edits, preparing and completing claims for submission to payers, and updating patient accounting systems. The Billers/AR follow-up also perform related functions in support of the Patient Financial Services operations and other duties, as assigned.
Specific Duties and Responsibilities:
Senior Hospital Care Investigator
• Oversees complete both paper and electronic claims, in a timely manner, for review and processing by the Supervisor
• Oversees HCIs and effectively use all hospital patient accounts computer systems,
• Document patient information clearly and completely in the Epic billing systems
• Interact with other departments to complete billing on accounts
• Refer accounts requiring escalation to Supervisor in a timely manner
• Attend all necessary training sessions to effectively perform the day-to-day functions of the position
• Perform all other duties, as assigned by the Patient Accounts Manager or Supervisor
• Supervises a unit engaged in medical assistance, investigation activities, assigning, and controlling the flow of work, training and advising subordinates in difficult matters. Evaluating staff and recommending appropriate personnel action when indicated.
• Corrects case records and/or recommendations for approval or denial and for appropriateness of category assistance.
• Review applications for in-patient care and determines eligibility for other medical assistance. Reviews all insurances for correctness, reviews productivity reports to maintain productivity and quality of performance.
• May conduct special or emergency investigations, or investigations of a more difficult or complex nature.
• Interprets departmental, City, State and Federal rules and regulations for the staff.
• Maintains statistical records and prepares status reports.
• Facilitate billing third party payers/patients and resolve insurance denial.
• Document all work done accordingly.
Minimum Qualifications
Six months of service as a Hospital Care Investigator.
Department Preferences
• Knowledgeable of the revenue cycle process and required fields to update in the Epic Financial system.
• The ability to review, appeal and make corrections to all claim edits and denials.
• Understand the process to prepare and complete claims for submission to all qualifying payers.
• The ability to supervisor all HCIs on how to perform related functions in support of the Epic Patient Financial system.
If you wish to apply for this position, please apply online by clicking the "Apply Now" 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
