Hosp Care Investigator

About NYC Health + Hospitals

NYC Health + Hospitals/North Central Bronx (NCB) is a member facility of the New York City Health + Hospitals system, one of eleven acute care facilities within the City of New York. A 215-bed community hospital, NCBH specializes in women’s and children’s services. It also provides Behavioral Health acute and ambulatory care. Its busy outpatient department has led the way in community-based care delivered in a compassionate and culturally-appropriate manner. It’s Labor and Delivery service safely brings more than 800 babies into the world each year. NCBH is committed to providing safe, high-quality medical care for any and all in need.

Work Shifts

Tour 2: 9am to 5pm

Duties & Responsibilities

• Informs patient of health care setting rates;
• performs in-depth interviews with patients, families, relatives and friends in an office setting or the health care setting, during field investigations, and/or by telephone to determine patients’ and/or legally responsible relatives’ ability to pay for services rendered;
• Contacts outside agencies, organizations, insurance carriers and employers to obtain necessary information about potential sources of revenue;
• Acts as a liaison with social services and home care agencies;
• Refers patients to various health care setting departments and outside agencies, such as Medicaid, New York State Unemployment Insurance, Social Security and Public Assistance for possible benefits;
• Facilitates processing of patients’ applications for third-party benefits, including but not limited to Medicaid and Medicare;
• Reviews and abstracts medical charts to obtain pertinent information for accurately coding and completing third-party billing forms, indicating treatment given, discharge diagnoses and overall patient information for computerization purposes;
• Reviews patient account records to ensure patients are properly billed; verifies and corrects patient bills and codes information for computerized system;
• Verifies accuracy of patient information stored in computer and codes changes and modifications, as necessary;
• Responds to complex inquiries from patients and third-party payers and resolves disputes concerning bills submitted for payment;
• Follows-up on collections to ensure maximization of revenue.

Minimum Qualifications

• A baccalaureate degree from an accredited college or university; or
• An Associate’s degree from an accredited college or university; and completion of an accredited certificate program in medical billing; or
• 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
• 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
• Educational 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 diploma or its educational equivalent.

Benefits

• Comprehensive Health Benefits for employees hired to work 20+ hrs. per week
• Retirement Savings and Pension Plans
• Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts
• Loan Forgiveness Programs for eligible employees
• College tuition discounts and professional development opportunities
• College Savings Program
• Union Benefits for eligible titles
• Multiple employee discounts programs
• Commuter Benefits Programs

How To Apply

If you wish to apply for this position, please apply online by clicking the "Apply for Job" button.