Hosp Care Investigator
3 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.
Visit us at www.nyc.gov/html/hhc/lincoln.
Job Description
Position Summary:
A member of the revenue cycle process, the Follow-up Representative is responsible for contacting insurance payers to review claims that have not been paid after a reasonable period of time and follow through to resolution. The Follow-up Representative is responsible for knowing the current rules and regulations for each payer. Major responsibilities include account research, potentially rebilling accounts, and seeing accounts with pending balances through to resolution.
Essential Job Functions:
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 that may be assigned to the position within the revenue cycle process.
- Ensure compliance with payer rules and regulations
- Perform routine follow-up on outstanding insurance balances
- Review and work appropriate accounts to maximize A/R reduction and minimize write-offs
- Review payer denials and underpayments and work to resolution
- Complete claims for review and processing by the Supervisor
- Interact with other departments to resolve outstanding payer balances
- Refer accounts requiring escalation to the 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 Accounting Manager or Supervisor.
Minimum Qualifications
1. A baccalaureate degree from an accredited college or university; or
2.An Associate's degree from an accredited college or university; and completion of an accredited certificate program in medical billing; or
3.A four-year high school diploma or its educational equivalent; and completion of an accredited certificate program in medical billing; and two (2) years of full-time experience in interviewing, investigation, or a related field, such as credit and collection follow-up or bookkeeping, or as a customer service representative providing comprehensive customer service entailing the dispensing of information or listening to and resolving customer's concerns, problems and complaints or troubleshooting; or
4.A four-year high school diploma or its educational equivalent; and four (4) years of full-time experience, as described in #3 above, at least two years of which must have been in interviewing, investigations, or a related field such as credit and collection follow-up or bookkeeping; or
5.Education and/or experience which is equivalent to (1), (2), (3) or (4) above. College education may be substituted for experience on the basis that thirty (30) semester credits are equivalent to one (1) year of experience and candidates must have completed an accredited certificate program in medical billing or have at least two years of full-time experience in interviewing, investigations, or a related field such as credit and collection follow-up or bookkeeping. In addition, all candidates must have at least a four-year high school diploma or its educational equivalent.
If you wish to apply for this position, please apply online by clicking the "Apply Now" button or forward your resume, noting the above Job ID #, to:
Lincoln Medical & Mental Health Center
Human Resources Department
234 Eugenio Maria De Hostos Blvd, (East 149th Street),
2nd Floor, Annex
Bronx, NY 10451
Attn: Recruitment Unit
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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