Hospital Care Investigator

Hospital Care Investigator / Medical Biller

A large healthcare organization in New York City is seeking a Hospital Care Investigator / Medical Biller to support Patient Financial Services and revenue cycle operations. This position is responsible for backend medical billing activities, including claim edits, insurance billing, claims processing, denial management, payment posting, account follow-up, and resolution.

Responsibilities:

• Review patient accounts and correct billing and claim edits.
• Prepare and complete paper and electronic claims for timely submission to insurance payers.
• Perform backend insurance billing and claims processing activities.
• Investigate rejected and denied claims and perform appropriate follow-up through resolution.
• Post payments and apply account adjustments as appropriate.
• Update patient accounting and billing systems accurately and completely.
• Document patient information, billing activity, and customer interactions in applicable systems.
• Work with other departments to obtain information necessary to complete account billing.
• Process pre-authorizations, document responses, and perform required follow-up.
• Audit patient accounts for accuracy and identify discrepancies requiring correction.
• Provide billing customer service and accurately document conversations and outcomes.
• Process patient statements and enter relevant information into billing databases.
• Review past-due balances and follow up with patients and insurance carriers.
• Generate and review Patient Balance Aging and Insurance Aging reports and perform appropriate follow-up.
• Arrange payment schedules with patients when applicable.
• Escalate accounts requiring additional intervention to the appropriate supervisor.
• Attend required training sessions and maintain knowledge necessary to perform assigned revenue cycle functions.
• Perform additional Patient Financial Services and revenue cycle duties as assigned.

Qualifications:

• Bachelor's degree from an accredited college or university; or
• High school diploma or recognized educational equivalent and four years of full-time experience in interviewing, investigation, credit and collection follow-up, bookkeeping, or a related field; or
• An equivalent combination of education and experience. Thirty semester college credits may substitute for one year of experience.
• A high school diploma or recognized educational equivalent is required for all candidates.
• Experience with medical billing, preferably including backend healthcare billing.
• Experience with billing edits, claim denials, claims follow-up, and resolution.
• Experience with insurance billing and claims processing.
• Epic experience strongly preferred.
• Ability to process both paper and electronic claims.
• Strong computer and patient accounting system skills.
• Ability to maintain accurate and complete account documentation.
• Knowledge of payment posting, adjustments, aging reports, and collection follow-up.
• Ability to communicate effectively with patients, insurance carriers, and internal departments.
• Must be available to participate in an in-person interview.

Please note that the salary range and/or hourly rate range of $20.00 to $24.00 per hour is a good faith determination of potential base compensation offered to applicants at the time of this job advertisement and may be subject to modification in the future. When determining a team member's base salary and/or hourly rate, various factors may be taken into account as applicable (such as location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget, and internal equity). For consideration to this and/or other roles suitable for your background, please submit your most up-to-date resume to join our talent pool. At ATRIA Consulting, LLC, we are a woman-owned business fully committed to promoting, cultivating, and maintaining a culture of diversity, equity, and inclusion. We embrace and celebrate differences across all demographics and backgrounds. We encourage everyone to apply.