Hospital Care Investigator - Provisional

About the organization

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 700,000 outpatient visits annually. Bellevue is an academic medical institution of international renown and an incubator for major innovations in public health, medical science, and medical education. Bellevue is a Level I Trauma Center delivering round‑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. 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, the mission is to deliver high‑quality health services without exception, guided by the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence).

Responsibilities

• Inform patients of health‑care setting rates.
• Conduct in‑depth interviews with patients, families, relatives, and friends in person, by telephone, or in the field to determine ability to pay for services.
• Contact outside agencies, organizations, insurance carriers, and employers to obtain information about potential sources of revenue.
• Act as a liaison with social services and home‑care agencies.
• Refer patients to internal departments and external agencies such as Medicaid, New York State Unemployment Insurance, Social Security, and Public Assistance for possible benefits.
• Process patients’ applications for third‑party benefits, including Medicaid and Medicare.
• Review and abstract medical charts to obtain information for accurate coding and completion of third‑party billing forms.
• Review patient account records to ensure proper billing, verify and correct bills, and code information for the computerized system.
• Verify accuracy of patient information stored in the computer and make necessary changes or modifications.
• Respond to complex inquiries from patients and third‑party payers and resolve billing disputes.
• Follow up on collections to maximize revenue.

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 high school diploma (or equivalent) and completion of an accredited certificate program in medical billing plus two years of full‑time experience in interviewing, investigation, credit and collection follow‑up, bookkeeping, or comprehensive customer service; or
• A high school diploma (or equivalent) and four years of full‑time experience as described above, with at least two years in interviewing, investigations, or a related field; or
• Education and/or experience equivalent to any of the above, with college credits counted at a ratio of thirty semester credits per year of experience, provided the candidate has completed an accredited certificate program in medical billing or has at least two years of full‑time experience in the relevant fields, and possesses a high school diploma (or equivalent).