Hospital Care Investigator/Medical Billler

Job Description

Job Description

A large healthcare organization in New York City is seeking an experienced Hospital Care Investigator / Medical Biller to support its revenue cycle and Patient Financial Services operations. This non-patient-facing position focuses on backend medical billing, claim processing, billing edits, denial management, payment posting, and insurance follow-up. The ideal candidate will have strong healthcare billing experience, including experience with EPIC and insurance claims.

Responsibilities:

• Review patient accounts and identify and correct billing and claim edits.
• Prepare and complete paper and electronic claims for timely submission to insurance payers.
• Process insurance claims, rejections, denials, and related correspondence.
• Perform follow-up activities on outstanding claims and resolve billing issues.
• Post payments and apply appropriate account adjustments.
• Update patient accounting and billing systems accurately and completely.
• Document patient, insurance, and account information clearly in applicable systems.
• Process prior authorizations, document responses, and perform necessary follow-up.
• Audit patient accounts to ensure billing accuracy.
• Coordinate with internal departments to obtain information necessary to complete billing.
• Provide billing customer service and accurately document conversations and account activity.
• Process patient statements and enter billing information into applicable databases.
• Review past-due accounts and conduct appropriate patient and insurance follow-up.
• Generate and work Patient Balance Aging and Insurance Aging reports.
• Arrange payment schedules with patients when appropriate.
• Escalate accounts requiring additional review to a Supervisor in a timely manner.
• Attend required training sessions.
• Perform other related revenue cycle and Patient Financial Services duties as assigned.

Qualifications:

• Strong backend medical billing and healthcare revenue cycle experience.
• Experience with billing edits, claim denials, insurance follow-up, claims processing, denial management, and resolution.
• Experience using EPIC for billing or patient accounting strongly preferred/required based on the assignment requirements.
• Ability to effectively work with electronic billing and patient accounting systems.
• Strong attention to detail and ability to accurately document account activity.
• Ability to process both paper and electronic claims.
• Knowledge of payment posting, account adjustments, aging reports, insurance follow-up, and patient billing.
• Education/Experience: Non-clinical baccalaureate degree from an accredited college or university; or  High School diploma or recognized educational equivalent plus four years of full-time experience in interviewing, investigation, or a related field such as credit and collection follow-up or bookkeeping; or  An equivalent combination of education and experience. Thirty semester credits may substitute for one year of experience.
• 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.