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Sub-Investigator (Nurse Practitioner)
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Hospital Care Investigator
3 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
TOUR 2 - 9:00 A.M - 5:00 P.M
SUMMARY OF DUTIES AND RESPONSIBILITIES
- Completes notification, verification, and authorization for scheduled and non-scheduled visits, as assigned.
- Contacts insurance payers to secure authorizations for required services, verifies coverage and benefits.
- Coordinates with Case Management to ensure extended authorizations are secure.
- Communicates with physician offices regarding pre-certification requirements.
- Communicates with patients to obtain updated insurance information, as needed.
- Utilize insurance websites/portals to verify insurance coverage and obtains authorizations.
- Documents patient information clearly and completely in the Health Information System.
- Scans patient ID, insurance card(s), referral forms (if applicable) and consent forms obtained from the patient into document imaging system.
- Responsible for screening uninsured or under-insured outpatients to identify insurance coverage or enrollment eligibility into NYC Care, H+H Options, HRA and NYSOH Medicaid applications.
- Discusses Patient Copays, deductibles, assess and process patient payments by credit/debit card or refer patient to cashier for cash payments.
- Assists Pts with MyChart enrollments when needed.
- Interacts with other departments to financially secure accounts.
- Refers accounts requiring escalation to Supervisor in a timely manner.
- Attends all necessary training sessions and huddles to effectively perform the day-to-day functions of the position.
- Performs all other duties as assigned by the Patient Access Manager or Supervisors.
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 a certificate program in medical
billing; or
3. A four-year high school diploma or its educational equivalent; and completion of a 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; 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. However,
all candidates must have at least a four-year high school diploma or its educational equivalent.
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
