Hosp Care Investigator

2 weeks ago

New York, United States NYC Health + Hospitals Full time

**About NYC Health + Hospitals**:
NYC Health + Hospitals/Bellevue is America’s oldest public hospital, established in 1736. Affiliated with the NYU School of Medicine, the 844-bed hospital is a major referral center for highly complex cases, with its 6,000 employees including highly skilled, interdisciplinary clinical staff. It sees more than 110,000 emergency room visits and 500,000 outpatient visits annually. Bellevue is an academic medical institution of international renown. We have served as an incubator for major innovations in public health, medical science, and medical education. Bellevue is a Level I Trauma Center delivering around-the-clock care in adult, pediatric, psychiatric and pediatric psychiatric emergencies as well as in the nationally-designated categories of cardiology, neurology, toxicology, and neonatology. In addition to providing comprehensive inpatient and outpatient state-of-the-art care Bellevue is a city-wide medical specialty referral source. Bellevue’s clinical centers of excellence include: Emergency Medicine and Trauma Care; Cardiovascular Services; Designated Regional Perinatal Center and Neonatal Intensive Care Unit (ICU); Comprehensive Children’s Psychiatric Emergency Program; and Cancer Services.

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.
- Establish your work priority based on the Days in WQ’ for each account and start with the oldest accounts.- On each account check in Epic admission type: ‘Elective’ or ‘Emergency’.
- Elective accounts may have preapproved authorization from insurance company obtained by Ambulatory Surgery Unit HCI. Review account notes and documents on file. Confirm with the insurance company via phone that the authorization covers the dates of service, verify benefits to complete the account.
- Verify the patient’s insurance - conduct system checks utilizing Systems not limited to: EPIC RTE responses, EPACES, CONNEX, AVAILITY, NAVINET, HHS CONNECT, HMO portals and commercial websites for hidden/uncovered insurance coverages.
- Check Media Manager for insurance cards, and documents that may have insurance info listed or other pertinent information that would be aide in verifying coverage (SSN, Out-of-State IDs, Ambulance/EMS Reports, transfer documents, etc.).
- Proof of verification MUST be scanned or uploaded into the document folder named “Insurance Eligibility Determination” and enter the insurance plan name into the column of Description.
- Reviewing eligibility (Epaces, Connex, RTE responses). If a commercial insurance appears on MCD, MCR, MCR/MCD HMO-s eligibility, it has to be added to the HAR, even if we verify that its inactive DOS.

**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,

**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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