Hospital Care Investigator

About the Facility

NYC Health + Hospitals/McKinney is a 320-bed skilled nursing and rehabilitation facility in Brooklyn with a 5-Star CMS Rating in staffing, quality, health inspections, and overall. McKinney provides exceptional short-term rehabilitation and long-term skilled nursing services in a warm and comfortable setting. Residents have 24-hour access to expert care and specialty services including Parkinson’s and Dementia Care, Hospice and Palliative care, IV therapy, wound and tracheostomy care.

From more than 600 Nursing Homes in New York, McKinney ranks #11 in Newsweek’s Best Nursing Homes in New York 2026 and earned high-performance ratings for Long-term Care and Short-term Rehabilitation from U.S. News & World Report’s Best Nursing Homes in America 2026.

At NYC Health + Hospitals, our mission is to deliver high-quality 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.

Responsibilities

Under direct supervision, conducts investigations in a health care setting to determine eligibility of applicants for medical assistance payment programs or the ability of patients and their legally responsible relatives to pay for hospital or health care charges. Takes necessary actions to bill and collect for these services, explores alternative sources for payment, codes and verifies demographic and insurance data, and performs billing and collections functions to maximize revenue.

• Informs patients of health care setting rates.
• Performs in-depth interviews with patients, families, relatives, and friends in various settings (office, health care facility, field investigations, or by telephone) to determine 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 departments and outside agencies (e.g., Medicaid, New York State Unemployment Insurance, Social Security, Public Assistance) for possible benefits.
• Facilitates processing of patients’ applications for third-party benefits, including Medicaid and Medicare.
• Reviews and abstracts medical charts to obtain pertinent information for accurately coding and completing third-party billing forms.
• Reviews patient account records to ensure proper billing; verifies and corrects patient bills and codes information for computerized systems.
• 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.

Requirements

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, plus two (2) years of full-time experience in interviewing, investigation, or a related field (e.g., credit and collection follow-up, bookkeeping, or customer service involving comprehensive information dispensing or problem resolution); or
• A four-year high school diploma or its educational equivalent and four (4) years of full-time experience in the fields described above, with at least two years in interviewing, investigations, or related areas; or
• Education and/or experience equivalent to the above, with college education substituting for experience on the basis that thirty (30) semester credits equal one (1) year of experience. 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 related fields.

All candidates must have at least a four-year high school diploma or its educational equivalent.