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New York City

    Hospital Care Investigator - New York, United States - NYC Health Hospitals

    NYC Health Hospitals
    NYC Health Hospitals New York, United States

    1 week ago

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    Description
    NYC Health + Hospitals/Metropolitan is the community hospital of choice for residents of East Harlem, northern Manhattan, and neighboring communities. The hospital provides culturally-sensitive care in a welcoming and hospitable setting, emphasizing primary care medicine and utilizing the latest advances in medical science. Metropolitan delivers high quality health services with compassion, dignity, and respect to all, without exception. Since its founding in 1875, the hospital has been affiliated with New York Medical College, representing the oldest partnership between a hospital and a private medical school in the United States. Metropolitan is a part of the NYC Health + Hospitals, the largest municipal hospital and health care system in the country.

    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 2 8 AM - 4 PM

    Job Description

    • Conducts in-depth financial interviews with patients to obtain accurate demographics ( e.g. birthplace, current address & phone number, mother's maiden name, etc.) insurance eligibility or assists the uninsured with HHC Options that includes processing Medicaid applications (if eligible) and advises patient of various payment options.

    • Utilizes all available resources, e.g. insurance company websites, EPaces, Epic, ONBASE, AIM, and NYS Marketplace to process patient information/eligibility in order to obtain approval for their hospital inpatient stay.

    • Log into Epic on a daily-WQ & 11928

    • WQ-11920-ME HCJ AUTHICERT ADMISSION AND DISCHARGED-ensure inpatient notifications are notify in a timely manner. HCI is responsible for ensuring all due diligence is done for each case. E.g. Auth/cert, Benefit Collection/Pre-cert status. Follow-up will be required on any deferred case

    • WQ-11928-ME I-JC/ A UTHICERT MOM/BABY A DMJSSIONS & DISCHARGES-ensured admission notifications is process in a timely manner. HCI is responsible for interviewing baby's mother to obtain insurance information; if unavailable, HCI is responsible for proper follow-up. Newborn cases with no policy number should be deferred to a later date for follow-up

    • Maintains current access to all required software applications to perform assigned duties, by periodically resetting/changing passwords.

    • Updates demographics, insurance information, inputs authorizations into EPIC; documents activities relative to obtaining authorization/approvals in Epic Hospital Account notes.

    • Scans pertinent information into ONBASE under medical record number or HAR; for example - patient identification, insurance card, authorization letters, appeals, correspondence, etc.

    • Interviews Emergency Room patients to obtain insurance information and complete Medicaid Applications. Obtains signatures on Observation Forms.

    • Completes assignments in a timely manner; adheres to Financial Clearance Standard Work.

    • Consults with Senior Hospital Care Investigator, on problematic issues and/or cases to facilitate processing.

    • Functions as an integral Team member, communicating regularly and working collaboratively contributing to the operational flow within the Unit while enhancing the patient experience.

    • Actively participates in Unit/Departmental huddles on a daily/weekly basis.

    • Safeguards PHI (Protected Health Information) by keeping it insight or secured at the individual's workstation.

    • Practices patient confidentiality by not discussing specific patient related issues in open areas.

    • Demonstrates commitment and accountability to be culturally sensitive to internal & external customers, irrespective of race, color, national origin, religion, gender identity or sexual orientation.

    • Abides by Corporate, Hospital & Departmental policy regarding the use of a cell phone for emergency purposes only while at workstation.

    • Attends in-service, Departmental, Hospital & Healthcare related trainings. Maintains compliance with OHS annual assessment, Multistar, Fire Safety, HIP AA as well as Fraud & Abuse training.

    • Follows Departmental Policies & Procedures, including the call-in and dress code policies.

    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.

    In addition, you can submit your resume to with the Job Title and Job ID # of the job posting that you applied to in the subject line of the email.

    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
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