Hospital Care Investigator

Job SummaryWe are looking for individual to join our client’s team as Hospital Care Investigator. You will be part of the revenue cycle process, billers are responsible for reviewing accounts, correcting claim edits, preparing and completing claims for submission to payers, posting all types of payments, and updating patient accounting systems. They will perform related functions in support of the Patient Financial Services operations and other duties, as assigned. The identification of essential functions below is not intended to be an exhaustive list of all duties that may be assigned to this position, nor does it restrict the duties which may be assigned to the position within the revenue cycle process.

Job DescriptionComplete both paper and electronic claims, in a timely manner. Effectively use computer systems Document patient information clearly and completely in systems.Interact with other departments to complete billing on accounts.Process rejections, denials, and other correspondence in a timely manner.Process pre authorizations, documenting responses in the system and following up as needed Audit patient accounts for accuracy..Apply adjustments as needed.Provide billing costumer service and ensure that conversations are documented accurately.Processing statements and entering information into database; and reviewing past due bills and following up on past due accounts.Generate Patient Balance Aging report and Insurance Aging report and following with patients and insurances accordingly.Arrange payment schedules with patients.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 positionPerform all other duties, as assigned by the Manager or Supervisor.

Skills RequiredFour (4) years of full-time experience in interviewing, investigation, or a related field, such as credit and collection follow-up or bookkeeping.Finance hospital sideMedicaid ApplicationsBenefitsFinancial counseling, In patient and out Financial screeningFinancial Clearance

Education/Training/CertificationsBaccalaureate Degree from an accredited college or university; or High School diploma or its educational equivalent approved by the State Department of Education or a recognized accrediting organization.Education and/or experience which is equivalent to “1” or “2” above. College education may be substituted for 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 High School diploma or its educational equivalent approved by the State Department of Education or a recognized accrediting organization.Preferred- Portal enrollment – CACs certified application counselors and/or marketplace facilitated enrollers.

Additional RequirementsAlternating weekends must be available 7-3pm or 3pm –11pm

We are an Equal Opportunity Employer. Employment decisions are made without regard to race, color, religion, national or ethnic origin, sex, sexual orientation, gender identity or expression, age, disability, protected veteran status or other characteristics protected by law.

JOB-10041280