Since 1875, South Brooklyn Health has established its reputation for clinical excellence and culturally competent care. It has designations as a Certified Percutaneous Coronary Intervention (PCI) Center, an Advanced Primary Stroke Center, an accredited Baby-Friendly Hospital, a U.S. News & World Report high performing hospital. The hospital's staff is as diverse as the patients they serve. Interpreter services can be provided at any time of the day or night in over 130 languages.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 Shifts8:00 A.M - 4:00 P.M
Job DescriptionPurpose:A member of the revenue cycle process, Billers or AR Follow-up are responsible for reviewing accounts, correcting claim edits, preparing and completing claims for submission to payers, and updating patient accounting systems. The Billers also perform related functions in support of the Patient Financial Services operations and other duties, as assigned.Specific Duties and Responsibilities:Hospital Care Investigator•Oversees complete both paper and electronic claims, in a timely manner, for review and processing by the Supervisor•Effectively use computer systems,•Document patient information clearly and completely in the HIS and billing systems•Interact with other departments to complete billing on accounts•Refer accounts requiring escalation to Supervisor in a timely manner•Attend all necessary training sessions to effectively perform the day-to-day functions of the position•Perform all other duties, as assigned by the Patient Accounting Manager or Supervisor•Supervises a unit engaged in medical assistance, investigation activities, assigning, and controlling the flow of work, training and advising subordinates in difficult matters. Evaluating staff and recommending appropriate personnel action when indicated.•Reviews case records and/or recommendations for approval or denial and for appropriateness of category assistance.•Review applications for in-patient care and determines eligibility for other medical assistance. Reviews all insurances for correctness, reviews all DP reports to maintain productivity and quality of performance.•May conduct special or emergency investigations, or investigations of a more difficult or complex nature.•Interprets departmental, City, State and Federal rules and regulations for the staff.•Maintains statistical records and prepares status reports.•Facilitate billing third party payers/patients and resolve insurance denial.•Document all work done accordingly.
Minimum Qualifications1. A Baccalaureate Degree from an accredited college or university; or2. An Associate's degree from an accredited college or university; and completion of a certificate program in medicalbilling; or3. A four-year high school diploma or its educational equivalent; and completion of a certificate program in medicalbilling; and two (2) years of full-time experience in interviewing, investigation, or a related field, such as credit andcollection follow-up or bookkeeping, or as a customer service representative providing comprehensive customerservice entailing the dispensing of information or listening to and resolving customer's concerns, problems andcomplaints or troubleshooting; or4. A four-year high school diploma or its educational equivalent; and four (4) years of full-time experience, asdescribed in #3 above; or5. Education and/or experience which is equivalent to (1), (2), (3) or (4) above. College education may be substitutedfor 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.
Department Preferences•Knowledgeable of the revenue cycle process and required fields to update in the Epic Financial system•The ability to review, appealand make corrections to all claim edits and denials•Understand the process to prepare and complete claims for submission to all qualifyingpayers•The ability to supervisor all HCIs on how to perform related functions in support of the Epic Patient Financial system.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