Hospital Care Investigator -HCI24-07208 - Positive Work Culture

Title: Hospital Care Investigator
Location: Manhattan, NY
Duration: 2months

Shift Time: Mon-Fri 9am-5pm

Job Description:

As a vital member of the revenue cycle process, the Hospital Billing Specialist plays a pivotal role in ensuring accurate and timely billing procedures within the healthcare facility. Responsible for various tasks within the Patient Financial Services operations, the incumbent will meticulously review accounts, rectify claim discrepancies, and meticulously prepare claims for submission to payers. Additionally, the Hospital Billing Specialist will be proficient in processing both paper and electronic claims, adeptly navigating computer systems, and meticulously documenting patient information within designated databases.

Key Responsibilities:

1. Review accounts thoroughly, rectify claim edits, and ensure the completeness and accuracy of claims before submission to payers.
2. Efficiently process both paper and electronic claims, adhering to established guidelines and timelines.
3. Maintain clear and comprehensive documentation of patient information within designated systems.
4. Collaborate effectively with other departments to streamline billing processes and resolve account-related inquiries.
5. Promptly address rejections, denials, and other correspondence to facilitate timely resolution.
6. Process pre-authorizations, meticulously documenting responses and ensuring appropriate follow-up actions.
7. Conduct audits on patient accounts to ensure accuracy and compliance with regulatory requirements.
8. Apply adjustments to accounts as necessary, ensuring adherence to established protocols.
9. Provide exemplary customer service in billing-related inquiries, ensuring accurate documentation of all interactions.
10. Process statements and input relevant information into the database, diligently reviewing past-due bills and following up on outstanding accounts.
11. Generate and analyze Patient Balance Aging and Insurance Aging reports, taking appropriate actions to follow up with patients and insurance companies.
12. Facilitate payment arrangements with patients and escalate accounts requiring further attention to the Supervisor promptly.
13. Attend all mandatory training sessions to remain updated on industry standards and effectively perform assigned duties.
14. Perform additional duties as assigned by the Manager or Supervisor to support departmental objectives.

Education and Experience Requirements:

• Bachelor's Degree from an accredited college or university is preferred. Alternatively, a High School diploma or its educational equivalent approved by the State Department of Education or a recognized accrediting organization, coupled with four (4) years of full-time experience in interviewing, investigation, or a related field, such as credit and collection follow-up or bookkeeping, is required.
• Equivalent combinations of education and experience may be considered. Thirty (30) semester credits may substitute for one (1) year of experience. However, all candidates must possess at least a High School diploma or its educational equivalent approved by the State Department of Education or a recognized accrediting organization.