Hospital Care Investigator

About the Role

The Hospital Care Investigator role is a critical part of the Patient Accounts unit, focused on revenue cycle operations at a healthcare facility in New York, NY. This is a 2-month contract assignment with strong prospects for extension, operating during standard business hours from 9:00 AM to 5:00 PM. Candidates should expect on-site interviews and workplace presence.

Responsibilities

• Review patient accounts thoroughly and correct any claim edits.
• Complete and submit both paper and electronic insurance claims promptly.
• Post payments and update the patient accounting system accurately.
• Effectively document and maintain clear patient information within computer systems.
• Coordinate with various departments to complete billing activities on accounts.
• Manage claim rejections, denials, and related correspondences proactively.
• Process pre-authorizations and monitor follow-up actions.
• Audit patient accounts for accuracy and apply necessary adjustments.
• Deliver billing customer service, documenting communication appropriately.
• Generate and manage reports such as Patient Balance Aging and Insurance Aging.
• Arrange payment plans with patients and escalate complex accounts to supervision.
• Attend all training sessions required to maintain proficiency in daily functions.
• Perform additional tasks as assigned by management within the revenue cycle process.

Qualifications and Skills

• Experience with medical billing processes including billing edits, denials, and claims follow-up.
• Practical knowledge of EPIC software and insurance billing workflows.
• Proficiency handling paper and electronic claims processing.
• Strong computer literacy for billing systems and patient documentation.
• Effective communication skills in English, including speaking, reading, and writing.
• Ability to interact with multiple departments and manage billing enquiries.
• Attention to detail in auditing accounts and managing reports.

Additional Information

• Educational requirement: High School diploma or GED equivalent.
• The shift is from 9 AM to 5 PM onsite in New York, NY, zip code 10037.
• Equal Employment Opportunity Employer, with a commitment to non-discrimination across various protected characteristics.