Hospital Care Investigator *Provisional*

New York, New York


Employer: NYC Health Hospitals
Industry: REGISTRATION OFFICE
Salary: Competitive
Job type: Full-Time

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 500,000 outpatient visits annually. Bellevue is an academic medical institution of international renown. We have served as an incubator for major innovations in public health, medical science, and medical education. Bellevue is a Level I Trauma Center delivering around-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. Bellevue's 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, 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
- Review work queue and prioritize accounts.
- Review Epic Interactive Face Sheet and Response History to verify accuracy of patient's information and check list is green.
- Check HAR and Guarantor to ensure that insurance information is correct and COB is correctly ordered.
- Search Media Manager, provider portals, other database, e.g. HHS Connex, OAM etc., to obtain/rule-out health insurance.
- Review and abstract medical charts to obtain pertinent patient information.
- Performs in-depth interview with patients, families, relatives, or by telephone to determine/rule out patient's and/or legally responsible relatives' active insurance, obtain financial information to facilitate processing of third-party benefits, and to verify demographics when discrepancies are found.
- Verify benefits eligibility utilizing the provider portals or call insurance carriers that does not have a portal.
- Obtain authorization by either calling, faxing or using insurance provider portal as needed.
- Appropriately document account information in the HAR and complete AUT/Cert and Benefits Collection.
- Complete checklist and upload all documents and correspondence to Media Manager.
- Log into EPIC to view the accounts assigned to you on your work queue and other work queues specified by leadership and/or the leader assigning cases for the day.
- Check Media Manager for insurance cards and documents that may have insurance information listed or other pertinent information that would be beneficial and would aide in verifying coverage (SSNs, out of state IDs, Ambulance/EMS reports, transfer documents, etc.)
- If you have substantial patient's info at hand, perform systems check for insurance coverage via RTE and if necessary, OAM, EDM, E-PACES, HHS connect, Bluemark and other insurance websites.
- If eligibility is verified via-website, scan or upload proof of verification.
- Follow-up with interview upon receiving into your EPIC work queue and make second interview attempt if necessary.
- Verify all demographic information.
- Create Finance Assistance Case after interview has been conducted,
- Create financial trackers if necessary.
- For patients without insurance (true self-pay) based on assessment or patient's request, complete a Medicaid application via NYSOH (assess for disability MA application/Surplus prior to submitting via NYSOH) or Bluemark.
- All other duties as assigned by Supervisor or designee.

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.

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: 2024-06-07
Reference: 104798
Country: United States
State: New York
City: New York
ZIP: 10036


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