Hospital Care Investigator
1 month ago
Location: New York, NY, 10016
Initial Duration: 8 weeks with possible extension
Shift Time: 9 am to 5 pm any 5 days in a week.
Pay Range: $25 - $28/hr. on w2.
Job Description:
- 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 assigned.
- 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.
Skills:
- Complete both paper and electronic claims, in a timely manner. Effectively use computer systems Document patient information clearly and completely in systems. Interact with other departments to complete billing on accounts.
- Process rejections, denials, and other correspondence in a timely manner. Process pre authorizations, documenting responses in the system and following up as needed Audit patient accounts for accuracy.
- Apply adjustments as needed. Provide billing customer service and ensure that conversations are documented accurately. Processing statements and entering information into database; and reviewing past due bills and following up on past due accounts.
- Generate Patient Balance Aging report and Insurance Aging report and following with patients and insurances accordingly.
- Arrange payment schedules with patients. Refer accounts requiring escalation to 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 Manager or Supervisor.
Additional Description:
- Perform in-depth interviews with self-pay and/or insured patients, families, relatives and friends in an office setting or the hospital wards, during field investigations, and/or by telephone, email and mail to determine patients' and/or legally responsible relatives' ability to pay for services rendered.
- Responsible for screening uninsured or underinsured patients to identify insurance coverage or enrollment eligibility from WQ 9195, 9284
- When necessary, obtain signatures for Medicaid application.
- Collect vital documents to complete and submit Medicaid application.
- Review and abstract Medical charts and Epic Media Manager program to obtain pertinent information for Insurances purposes.
- Review patient account records to ensure patients are billed, verify and correct patient demographics.
- Utilize insurance websites/portals to verify insurance coverage information and/or other pertinent information that would aide in verification of coverage.
- Complete and submit Medicaid Applications, Charity Care programs for eligible patients.
- Assists patients that do not qualify for Medicaid enrollment with charity care programs.
- Ensure all documentation is complete and submitted for program applications.
- Complete thorough HAR notes.
- Update and enter notes on all appropriate trackers.
- Perform routine follow-up on outstanding self-pay balances in WQ 9197, 9294
- Acts as liaison with social services and Client
- Consult senior or supervisor with any questions, refer accounts requiring escalation to supervisor in a timely manner.
- Compliance with all departmental, corporate, hospital regulations, policies, procedures, and conformity to established time and leave requirements.
- Time and Leave policy.
- Dress code.
- Wear ID badge.
- Appropriate professional conduct always towards patients, families, visitors, and co-workers.
- Attend all necessary training sessions to effectively perform the day-to-day functions of position.
- Qualifications:
- NYSOH CAC
- Blue mark
- Revenue Cycle Trainings
Required Experience & Education:
- High School Diploma
- Bilingual Spanish English
- Length of contract: 8 weeks
- Confirm job specs are accurate & Detailed:
- Data Entry
- Computer Skills
- Documenting
- Multitask
- Insurance
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