Hospital Care Investigator - HCI 24-18250

Job Title: Hospital Care Investigator 

Location: NYC, NY 10037

Duration: 2 Months

Job Details:

• Minimum Degree Required: Bachelor’s Degree
• Work Hours: 35 hours per week (7 hours per day, 5 days per week)

Duties:
As a key member of the revenue cycle process, the Hospital Care Investigator is responsible for reviewing accounts, correcting claim edits, preparing and completing claims for submission to payers, posting various types of payments, and updating patient accounting systems. The role includes performing related functions in support of Patient Financial Services operations and other assigned duties. The identification of essential functions below is not intended to be an exhaustive list of all duties for this position.

Key Responsibilities:

• Complete both paper and electronic claims in a timely manner.
• Effectively use computer systems to document patient information clearly and completely.
• Interact with other departments to complete billing on accounts.
• Process rejections, denials, and other correspondence promptly.
• Handle pre-authorizations, document responses in the system, and follow up as needed.
• Audit patient accounts for accuracy and apply adjustments when necessary.
• Provide billing customer service while ensuring conversations are documented accurately.
• Process statements, enter information into databases, and review past-due bills, following up on delinquent accounts.
• Generate Patient Balance Aging and Insurance Aging reports and follow up with patients and insurers as required.
• Arrange payment schedules with patients and escalate accounts requiring additional action to supervisors in a timely manner.
• Attend necessary training sessions to effectively perform day-to-day functions.
• Perform additional duties as assigned by management.

Qualifications:

• Education:
  • Bachelor’s Degree from an accredited college or university.
  • Alternatively, a High School diploma or equivalent approved by a recognized accrediting organization and four (4) years of full-time experience in interviewing, investigation, or related fields such as credit/collection follow-up or bookkeeping.
  • College education may substitute for experience at a rate of 30 semester credits equaling one (1) year of experience. A High School diploma or equivalent is mandatory.

Skills:

• Proficiency in completing both paper and electronic claims.
• Strong computer and documentation skills.
• Excellent communication and collaboration with various departments.
• Ability to process rejections, denials, and correspondence efficiently.
• Strong auditing, adjustment, and account reconciliation capabilities.
• Customer service skills for billing inquiries and conversations.
• Ability to manage payment arrangements and escalate issues when needed.
• Proficiency in generating and analyzing aging reports for follow-ups.

Languages Required:

• English (Speak, Read, Write)
• Spanish (Speak, Read, Write)
• French (Speak, Read, Write)