Harlem Hospital Center has been a bedrock of the Harlem community since 1887. The hospital provides a wide range of medical, surgical, diagnostic, therapeutic and family support services to the residents of Central Harlem, West Harlem, Washington Heights and Inwood. Harlem is the largest hospital in the area, capable of treating the most seriously ill. Harlem provides over 90 specialized ambulatory care services, dentistry and oral surgery, behavioral health services, and community substance abuse treatment.

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.

Duties & Responsibilities

Hospital Care Investigators (HHC), under direct supervision, conduct investigations in NYC Health and Hospitals Corporation (HHC) hospitals and health care facilities to determine the 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 and take the necessary actions to bill and collect for these services; explore alternative sources for payment of hospital or health care services rendered; verify, modify and code demographic and insurance data obtained from source documents, and enter such data into a computerized system; perform billing and collection functions in order to obtain maximization of a hospital's or health care facility's revenue. All Hospital Care Investigators (HHC) perform related work.

SUMMARY OF DUTIES AND RESPONSIBILITIES:

• Provides World Class Customer Service, via verbal and non-verbal communication, in a polite, pleasant and respectful manner.
• Acknowledges and meets the physical, emotional and spiritual needs of our internal and external customers.
• Demonstrates commitment and accountability to deliver World Class Customer Service.
• Member of an investigative Inpatient/Outpatient unit engaged in verifying insurance, obtaining authorization, interviewing Patients and referring or enrolling them in the appropriate financial category.
• Safeguards all PHI (Protected Health Information) by keeping it in sight, on your person or secured at the individual's respective work station.
• Prepares and maintain required statistical reports: productivity, billing rejections, denials, resubmissions.
• Utilizes all available resources included but not limited to SMS, WMS, Verifone, EPIC and Internet.
• Acts as liaison with Social Services and Home Care; various departments within the hospital, insurance companies and outside agencies.
• Reviews abstracts and medical charts to obtain pertinent info accurately coding and completing 3rd party billing forms indicating treatment given discharge diagnoses and overall patient information for revenue enhancement.
• Makes all appropriate allowances and money transfers.
• Interviews patients for insurance information and/or relatives if necessary.
• Member of a unit of HCIs engaged in Third Party Investigation to ascertain patient's financial ability to pay for Hospital services through processing patient information by financial clearance, completion of Medicaid applications, verification of Third-Party Insurance coverage, obtaining insurance authorizations, and fee scaling patients under HHC Options.
• Ensures that policies and procedures are followed.
• Participates in staff meetings and in-service trainings+B45 as required.
• Responsible for enhancing personal development through attendance at external and H+H Hospitals sessions.
• Exhibits flexibility within Northern Manhattan Network as it pertains to work assignment, workplace, site designation and Tour of Duty.
• Promotes a positive and pleasant attitude conducive to the workplace which enhances and further the Mission, Vision and Value Statement of the Department and Hospital.
• Complies with Corporate and Departmental dress code policy requiring appropriate attire while on duty or off-site work.
• Abides by Corporate and Departmental policy regarding the use of a cell phone for emergency purposes only, at your workstation or on duty.
• Meets all compliance requirements such as Multistar, HIPAA, fire drill participation, OHS annual physical/assessment, Right to Know, etc.

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 a certificate program in medical billing; or
3. A four-year high school diploma or its educational equivalent; and completion of a 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; 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. However, 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