Hospital Care Investigator

New York, New York


Employer: NYC Health Hospitals
Industry: PATIENT ACCOUNTS
Salary: Competitive
Job type: Full-Time

Woodhull Medical and Mental Health Center is attuned to the healthcare issues that matter to the people of North Brooklyn. Woodhull focuses on preventing disease and promoting healthy lifestyles by reaching out to the community at various locations.

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.

Job Description

Tour 2 (9:00am - 5:00pm)

PURPOSE OF POSITION:

A member of the revenue cycle process, the Insurance Verification Representative's primary responsibility is to perform all insurance verification, notification, and authorization activities. Major responsibilities include interacting with insurance companies, patients, physician offices, and other hospital departments to financially secure accounts.

AREAS OF RESPONSIBILITIES:

Patient Access, Insurance Verification and Financial Clearance

SUMMARY OF DUTIES AND RESPONSIBILITIES:

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 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 diploma or its educational equivalent.

Department Preferences

LANGUAGE COMPETENCIES: Spanish Speaking Preferred

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

Created: 2024-06-28
Reference: 108556
Country: United States
State: New York
City: New York
ZIP: 10036


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