Hospital Care Investigator - New York, NY - JS26-12308

Job Title: Hospital Care Investigator
Location: New York, NY
Job Type: Contract
Duration: 8 weeks
Shift: Day Shift | 9:00 AM – 5:00 PM | 3 × 11.5-hour shifts | 34.5 hours/week

Local Candidates Required: Yes
Traveler Candidates Required: Yes

Pay Rate: $24.00–$26.00/Hour

Required Qualifications

• High School Diploma or educational equivalent required.
• Bachelor's Degree from an accredited college or university preferred.
• 4 years of full-time experience in interviewing, investigation, credit and collection follow-up, bookkeeping, or a related field may substitute for a bachelor's degree.
• College education may be substituted for experience at a rate of 30 semester credits equivalent to one year of experience.
• At least a High School Diploma or recognized equivalent is required.
• Experience with paper and electronic claims processing.
• Experience using computer systems and documenting patient information.
• Experience with billing account interactions and patient accounting systems.
• Knowledge of claim rejections, denials, pre-authorizations, and account auditing.
• Strong billing customer service and communication skills.
• Ability to process information accurately and within required timelines.

Responsibilities

• Review patient accounts and identify billing issues or claim edits.
• Complete and process paper and electronic claims in a timely manner.
• Correct claim edits and prepare claims for submission to payers.
• Process rejections, denials, and other billing correspondence.
• Process pre-authorizations and document responses in the appropriate system.
• Audit patient accounts for accuracy and apply adjustments as needed.
• Document patient information clearly and completely in computer systems.
• Interact with other departments to resolve account and billing issues.
• Provide billing customer service and accurately document patient conversations.
• Process patient statements and enter information into databases.
• Review past-due accounts and follow up with patients and insurance companies.
• Generate and follow up on Patient Balance Aging Reports.
• Generate and follow up on Insurance Aging Reports.
• Arrange payment schedules with patients when appropriate.
• Refer accounts requiring escalation to the Supervisor in a timely manner.
• Maintain accurate patient accounting records.
• Attend required training sessions to effectively perform day-to-day responsibilities.
• Support Patient Financial Services and revenue cycle operations as assigned.
• Perform other duties as assigned by the Manager or Supervisor.