Systems Analyst

2 months ago

New York, United States NYC Health + Hospitals Full time

**About NYC Health + Hospitals**:
Carter is a leading, comprehensive specialty care hospital and nursing facility dedicated to providing quality medical, sub-acute, rehabilitative and long-term specialty services. We are committed to serving the New York City and surrounding communities while setting the example as a national leader in long-term and subacute care with centers of excellence in areas such as: geriatrics, rehabilitation and ventilator dependence.

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.

**Position Overview**:Under direct supervision, conducts investigations to determine the ability of patients and their legally responsible relatives to pay medical charges; explores alternative sources for payment for medical services rendered; verification of authorization and requests initial authorization for custodial care services; communicates regularly and working collaboratively with Central Admission team for the six (6) Post-Acute care facilities in pre-screening of all admission referrals to receive a consent/approval acknowledgment before client admission to Post-Acute Care facilities to obtain maximization of hospital’s revenue; adheres to financial clearance standard work; perform other related work.

**Responsibilities**:

- Conduct verbal communication with HARP insured before being admitted to PAC facility to educate them of their insurance policy not covering custodial long-term placement and encouraging the process to request disenrollment/transition to Mainstream Medicaid Managed Care plan to cover for Long long-term care Placement in Post-Acute Care Facility
- Communicate with potential residents/patients/designated representative on Medicaid guidelines as it relates to Medicaid eligibility with monthly NAMI responsibility, Medicaid transfer rules with penalty period, Medicaid recertification, Medicaid excess resources with financial agreement, Medicaid recertification and compliance with supplying updated financial documentation every year to recertify of continue Medicaid eligibility
- Explain monthly NAMI responsibility based on monthly income and request immediate re-routing of monthly income (Social Security, annuity payments, etc.)
- Explaining the Long-Term Placement process (MAP-2159I) for our Medicaid Managed Care insured and initiating a request for custodial authorization
- PAC admission agreement will be explained to potential new residents/patients and encouraged to sign upon agreement of transfer to a Post-Acute Care Facility
- Encourage signing of RFMS form before Post-Acute Care admission
- Answer questions/concerns courteously, offer guidance and escalate issues as needed to the Patient Account manager and Director
- Provides training and in-service for existing employees and new hires, provides support to staff development and process improvement to enhance quality of work activity, and communicates strategic departmental goals
- Participates in revenue cycle service monthly meetings and ensures adequate records of activities and problems are maintained as appropriate
- Complete special projects as assigned by the Patient Accounts Manager and Director
- Perform other duties as assigned and assist in coverage in the areas related to obtaining authorizations.

**Minimum Qualifications**:
1. A Baccalaureate Degree in a relevant field from an accredited college or university; and,
3. A Masters Degree in Management, Business Administration, Hospital Administration Management, Public Administration, Accounting or relevant field from an accredited college or university; or,
4. A satisfactory combination of education, training and experience.

**How To Apply**:
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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