Hospital Care Investigator

NYC Health + Hospitals/McKinney is a 320-bed skilled nursing and rehabilitation facility with a 5-Star CMS Quality Rating located in central Brooklyn. McKinney provides exceptional short-term rehabilitation and long-term skilled nursing services in a warm and comfortable setting. McKinney 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, McKinney ranks Top 30 in Newsweek's Best Nursing Homes in New York 2024; and also received high-performance ratings for Long-term Care and Short-term Rehabilitation from U.S. News & World Report's Best Nursing Homes in America 2024.

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
1. 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.
2. Contacts outside agencies, organizations, insurance carriers and employers to obtain necessary information about potential sources of revenue.
3. Acts as a liaison with social services and home care agencies.
4. 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.
5. Facilities processing of patients' applications for third-party benefits, including but not limited to Medicaid and Medicare.
6. 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.
7. Reviews patient account records to ensure patients are properly billed; verifies and corrects patient bills and codes information for computerized system.
8. Verifies accuracy of patient information stored in computer and codes changes and modifications, as necessary.
9. Responds to complex inquiries from patients and third-party payers and resolves disputes concerning bills submitted for payment.
10. Follows-up on collections to ensure maximization of revenue.

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.

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

Vacancy Control Board Number

VCB #: MKY-07172024-19247