Hospital Care Investigator

Kings County Hospital Center has a rich legacy for its pioneering role in medicine. Today, with over 625 beds, our hospital remains on the cutting edge of technology and provides the most modern procedures with state-of-the-art equipment. Built in 1831 as a one room infirmary for publicly supported care of the sick, Kings County Hospital Center continues to be a leading healthcare facility whose mission is to provide care to everyone regardless of their ability to pay. The hospital provides a wide range of health services, and specialties are offered in all fields of modern medicine. More than 200 clinics provide a wide array of ambulatory care services.

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.

Work Shifts

Tour II: 9:00 A.M - 5:00 P.M

Job Description

PURPOSE OF POSITION

A member of the revenue cycle process, the Hospital Care Investigator (HCI) is responsible for billing the payer and contacting insurance payers to review claims that have not paid after a reasonable period of time and follow through to resolution.

AREAS OF RESPONSIBILITIES

• Ensure compliance with payer rules and regulations.
• Billing various payers including Medicare and Medicaid
• Perform routine follow-up on outstanding insurance balances.
• Review and work appropriate accounts to maximize A/R reduction and minimize write-offs.
• Review payer denials and underpayments and work to resolution.
• Complete claims for review and processing by the Supervisor (Senior HCI).
• Interact with other departments to resolve outstanding payer balances.
• Refer accounts requiring escalation to Supervisor (Senior HCI) 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 the Senior HCI
• Promote a positive and pleasant attitude conducive to the workplace which enhance and furthers the Mission, Vision and Value Statements.
• Meet all compliance standard/requirements such as annual physical evaluation/assessments/mandatory in service and customer service.
• Demonstrate an awareness of all organization's Safety Plans.
• Participate in Performance Improvement Activities.
• Maintain professional attire in the workplace, as well as off-site when conducting business on behalf of the Central Brooklyn Network.
• Demonstrate an acceptable level of professional development through attendance at outside and Central Brooklyn Network Sessions.
• Take all necessary actions to ensure a safe environment.
• Secure patient records to assure confidentiality of information.
• Exhibit flexibility as it pertains to work assignment, work place site designation and tour of duty.

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