Hospital Care Investigator
3 weeks ago
Since 1875, South Brooklyn Health has established its reputation for clinical excellence and culturally competent care. It has designations as a Certified Percutaneous Coronary Intervention (PCI) Center, an Advanced Primary Stroke Center, an accredited Baby-Friendly Hospital, a U.S. News & World Report high performing hospital. The hospital's staff is as diverse as the patients they serve. Interpreter services can be provided at any time of the day or night in over 130 languages.
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
9:00 A.M - 5:00 P.M
Job Description
Purpose:
A member of the Revenue Cycle process, the HCI's s primary responsibility is to perform insurance verification, notification, and authorization activities. Responsibilities include interacting with insurance companies, patients, physician offices, and other hospital departments to financially secure accounts. Key roles also include interviewing patients and families to determine coverage eligibility, submitting applications for insurance coverage, and following-up on applications through resolution.
Specific Duties and Responsibilities:
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 which may be assigned to the position within the revenue cycle process.
• Key roles include interviewing patients and families to determine coverage eligibility, submitting applications for insurance coverage, and following-up on applications through resolution.
• Complete notification, verification, and authorization for scheduled and non-scheduled visits, as assigned.
• Contact insurance payers to secure authorizations for required services and verify coverage and benefits.
• Coordinate with Case Management to ensure extended authorizations are secure.
• Communicate with physician offices regarding pre-certification requirements.
• Communicate with patients to obtain updated insurance information, as needed.
• Utilize insurance websites/portals to verify insurance coverage and obtain authorizations.
• Document patient information clearly and completely in the Health Information System.
• Scan patient ID, insurance card(s), referral forms (if applicable) and consent forms obtained from the patient into document imaging system.
• Interact with other departments to financially secure accounts
• 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 Patient Access Director, 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 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 education.
Department Preferences
• Prior EPIC H2O Registration, Billing and Collections and/or Financial Counseling experience.
• Valid Certified Application Counselor Certification (CAC) preferred.
• Windows Office Suite.
• Excellent Customer Service skills required i.e. ICARE, communication and problem solving.
If you wish to apply for this position, please apply online by clicking the "Apply Now" button.
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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