Senior Hospital Care Investigator
2 weeks 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
9:00 A.M - 5:00 P.M
Job Description
PURPOSE OF POSITION
A member of the revenue cycle process, the Senior HCI is responsible for supervising HCIs, and conduct investigations to take the necessary actions to bill and collect for services. Review unpaid claims that have are delinquent after a reasonable period of time and follow through the resolution. Perform billing and collection functions; complete and/or review paper and electronic claims for proper and timely submission to insurance carriers. The Senior HCI is responsible for training, informing, and providing current procedures and guidelines to the HCIs.
AREAS OF RESPONSIBILITIES
Major responsibilities include more complex in-depth account research, re-billing accounts and seeing accounts with pending balances through to resolution
SUMMARY OF DUTIES AND RESPONSIBILITIES
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.
• Supervise a unit of Hospital Care Investigators responsible for revenue analysis, insurance verification, financial investigation, and other patient accounts' related activities
• Perform data management, exploratory data analysis, claim denials root cause analysis, and report findings to senior management
• Assess revenue metrics to maximize revenue and reduce denials
• Coordinates and monitors day-to-day activities of staff in the unit
• Monitors and reviews billing and collections in the AR Department
• Participate in department meetings
• Explains policy, rules and regulations for guidance of the staff as a case consultant on difficult cases
• Generate reports to monitor productivity and efficiency of the unit
Minimum Qualifications
Six months of service as a Hospital Care Investigator.
If you wish to apply for this position, please apply online by clicking the "Apply Now".
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
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