Senior Hospital Care Investigator

2 weeks ago


New York, United States NYC Health Hospitals Full time
Woodhull Medical and Mental Health Center is attuned to the healthcare issues that matter to the people of North Brooklyn. Woodhull focuses on preventing disease and promoting healthy lifestyles by reaching out to the community at various locations.

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


  • New York, United States NYC Health Hospitals Full time

    Since 1875, South Brooklyn Health has established its reputation for clinical excellence and culturally competent care. It has designations as a Certified Percutaneous Coronary Intervention (PCI) Center, an Advanced Primary Stroke Center, an accredited Baby-Friendly Hospital, a U.S. News & World Report high performing hospital. The hospital's staff is as...


  • New York, United States NYC Health Hospitals Full time

    Since 1875, South Brooklyn Health has established its reputation for clinical excellence and culturally competent care. It has designations as a Certified Percutaneous Coronary Intervention (PCI) Center, an Advanced Primary Stroke Center, an accredited Baby-Friendly Hospital, a U.S. News & World Report high performing hospital. The hospital's staff is as...


  • New York, United States NYC Health Hospitals Full time

    NYC Health + Hospitals/Gouverneur provides primary and specialty outpatient care through its Diagnostic and Treatment Center (D&TC) and residential care for the elderly and infirmed in its 295-bed Skilled Nursing Facility (SNF). Gouverneur recently completed a $250 million modernization project to offer enhanced, cutting edge healthcare services in a state...


  • New York, New York, United States City of New York Full time

    Job SummaryWe are seeking a highly skilled Senior Fraud Investigator to join our team at the City of New York. As a Senior Fraud Investigator, you will be responsible for conducting thorough investigations into fraudulent activities and ensuring that those responsible are held accountable.Key ResponsibilitiesConduct investigations into claims and collections...


  • New York, United States Eateam Full time

    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...


  • New York, New York, United States 1776 Senior Care Full time

    About 1776 Senior CareWe are a non-medical in-home care senior care agency dedicated to providing exceptional care and support to seniors in the comfort of their own homes.Our mission is to maintain independence and promote a high quality of life for our clients. We offer personalized care services that meet the unique needs of each individual we serve.Job...


  • New York, New York, United States Oscar Health Full time

    About the RoleThe SIU Investigator, Senior Analyst will be responsible for investigating changes in aberrant behavior observed in claims and enrollment data. This individual will work independently to analyze data, manage investigative caseload, and resolve cases through overpayment recovery, measuring behavior change, and completing necessary reporting to...


  • New York, New York, United States Financial Industry Regulatory Authority , Inc. Full time

    The Financial Industry Regulatory Authority, Inc. (FINRA) is dedicated to upholding the integrity of the securities industry through rigorous enforcement of rules and regulations. The Senior Investigative Analyst plays a pivotal role in examining potential violations of FINRA Rules and securities laws, contributing to the establishment of thorough and...


  • New York, New York, United States United Nations Full time

    Job SummaryThis is a challenging and rewarding opportunity to join the United Nations as an Investigator in the Operational Standards and Support Section (OSSS) at the Investigations Division (ID). The successful candidate will be responsible for conducting investigations, gathering evidence, and analyzing data to inform policy decisions.Key...


  • New York County, New York, United States Sunrise Senior Living Full time

    About the Role:Sunrise Senior Living is seeking a skilled Hospitality Ambassador to provide exceptional customer service and create a warm and welcoming environment for our residents, families, and visitors.Key Responsibilities:Monitor the Bistro area to ensure refreshments, music, and cleanliness meet our high standards.Perform general administrative duties...


  • New York, New York, United States Apex Systems Full time

    About the RoleWe are seeking a highly skilled and experienced professional to join our team as a Senior Manager, Employee Relations and Investigations. This role is a critical part of our Human Resources function and will play a key role in ensuring a positive and respectful work environment for all employees.Key ResponsibilitiesInvestigate and resolve...


  • New York, New York, United States Sunrise Senior Living Full time

    About the RoleWe are seeking a compassionate and dedicated Caregiver to join our team at Sunrise Senior Living. As a Caregiver, you will play a vital role in providing exceptional care and services to our residents, ensuring their physical, emotional, and social needs are met.ResponsibilitiesBuild meaningful relationships with residents and their families,...

  • Senior Associate

    1 week ago


    New York, New York, United States K2 Integrity Full time

    Job DescriptionK2 Integrity is seeking a skilled professional to join our Investigations and Disputes practice in the United States. Our team conducts thorough investigations to uncover critical information, enabling our clients to make informed decisions, maximize opportunities, reduce risks, and protect their integrity, personnel, and assets.As an...


  • New York, United States Maplewood Senior Full time

    ** Housekeeper - NYC Luxury Senior Living** **Job Category****:** Facilities **Requisition Number****:** HOUSE03692 Showing 1 location **Job Details** **Description** **Housekeeper - NEW Luxury Senior Living in NYC!** **Insp?r Senior Living, Maplewood Senior Livings new brand of world-class, urban senior living properties, is now hiring Housekeepers for its...

  • Hosp Care Investigator

    3 months ago


    New York, United States NYC Health Hospitals Full time

    NYC Health + Hospitals/Coler is an 815-bed nursing facility with a 5-Star CMS Quality Rating located on Roosevelt Island, nestled between Manhattan and Queens. Coler offers long term and subacute care, rehabilitation, and a dedicated memory care unit, comprised of 150 beds featuring an acclaimed music and memory program. The facility features a robust...

  • HR Investigator

    2 days ago


    New York, New York, United States Platinum Home Health Care Full time

    Job Title: HR Corrective Action Team InvestigatorJob Summary:The Corrective Action Team Investigator plays a crucial role in maintaining the quality of home health services by investigating incidents involving home health aides. This role involves assessing the validity of incidents, conducting thorough investigations, and recommending appropriate corrective...

  • Care Manager

    2 days ago


    New York, New York, United States Sunrise Senior Living Full time

    Job Summary:The Care Manager at Sunrise Senior Living is responsible for providing exceptional care and services to a consistent group of residents and their families in our assisted living and reminiscence neighborhoods.Key Responsibilities:Build Meaningful Relationships: Develop strong relationships with seniors and their families, providing assistance...

  • Care Manager

    4 days ago


    New York, New York, United States Sunrise Senior Living Full time

    Job Summary:The Care Manager at Sunrise Senior Living is responsible for providing exceptional care and services to a consistent group of residents and their families in our assisted living and reminiscence neighborhoods.Key Responsibilities:Build Meaningful Relationships: Develop strong relationships with seniors and their families, providing assistance...

  • Senior Associate

    2 months ago


    New York, United States K2 Integrity Full time

    Job DescriptionJob DescriptionK2 Integrity is looking for an associate to be a part of the Investigations and Disputes practice in the United States. K2 Integrity’s Investigations and Disputes practice uncovers and analyzes critical information that enables our clients to make informed decisions; maximize opportunities; reduce risks; and protect their...


  • New York, United States The Sage Group Full time

    Senior Manager, Employee Relations & InvestigationsThe Sage Group’s client is seeking a dynamic, organized self-starter to serve as Senior Manager, Employee Relations + Investigations. This role is based out of their New York headquarters (hybrid) and is part of the People team.The Senior Manager, Employee Relations + Investigations will report to the Sr....