Job description

About NYC Health + Hospitals

Coler is an 815 bed, leading nursing facility dedicated to providing quality medical, sub-acute, rehabilitative and long-term specialty services. We are committed to serving New York City, providing services to individuals requiring geriatric, memory care and rehabilitation services.

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.

Job Description

Hospital Care Investigators (NYC H+H), working out of our Coler location, under direct supervision, conduct investigations in NYC Health + Hospitals facilities to determine the eligibility of applicants for medical assistance payment programs, or the ability of patients and their legally responsible relatives to pay for hospital or health care charges and take the necessary actions to bill and collect for these services; explore alternative sources for payment of hospital or health care services rendered; verify, modify and code demographic and insurance data obtained from source documents, and accurately enter such data into computerized system(s) ensuring compliance with payor rules and regulations; perform billing and collection functions; complete and/or review paper and electronic claims for proper and timely submission to insurance carriers; follow up with insurance carriers, employers and/or patients for prompt payments; monitor and track denials and underpayments received from insurance carriers; complete non-clinical appeals when necessary; escalate accounts to supervisor in a timely manner in order to obtain maximization of a hospital’s or health care facility’s revenue. All Hospital Care Investigators (NYC H+H) perform related work.

Duties & Responsibilities

• Responsible for Managed Care collections
• Work closely with MDS team to ensure accurate submission of Managed Care billing
• Coordinates with the Case Management Team for missing and Continuing Authorizations
• Review and resubmit claims in Ability Network for denied or rejected claims
• Correct the claim Errors in Ability Network
• Review billing information in Point Click Care for discrepancies and correct as necessary
• Provide backup to entitlement coordinators for budget (NAMI) corrections.
• Generates month end claims and exports to Ability Network
• Check the exported claims in Ability Network if claims were released
• Attend the monthly Aging meeting and provides updates on Open Accounts
• Recommends claims for write off to Managers
• Opens and sort mails, scan mail as necessary into PointClickCare or Shared Drive
• Submits claims by mail if required
• Assists in other responsibilities assigned by Manager

Minimum Qualifications

• A Baccalaureate Degree from an accredited college or university; or
• Graduation from a Senior High School or a High School Equivalency Diploma; and
• Four (4) years of experience in interviewing, casework or a related field preferably in a hospital or health care facility setting; or
• A satisfactory equivalent combination of education, training and experience.

Department Preferences

• Minimum of one-year experience in Medicare billing
• Be cognizant of all HIPAA privacy rules to PHI
• Understanding of Federal and State guidelines and all other regulatory requirements for Medicaid billing and collection function
• Knowledge of SNF and LTAC billing and guidelines
• Proficiency in Microsoft Excel, Word, Access, PowerPoint
• Experience in utilizing an electronic medical record system such as Point Click Care

Please be advised that proof of Covid-19 vaccination is required prior to hire.

Coler-Goldwater Specialty Hospital & Nursing Facility
Human Resources Department
1 Main Street
Roosevelt Island NY 10044
Attn: Recruitment Unit
Fax: 212-318-4464

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

Job Type: Full-time

Pay: $47,705.00 per year

Benefits:

• 401(k)
• Dental insurance
• Flexible schedule
• Health insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift

Work Location: In person

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