4 Financial Investigator 1199 Line H9714 Jobs in Bronx, NY
BronxCare Health System is Hiring a Financial Investigator 1199 Line H9714 Near Bronx, NY
Overview
Secure pre-authorizations for medical and ancillary services. Communicate on a daily basis with practice managers, clinicians and staff to ensure that visits are appropriately registered, and meet all insurance pre-authorization requirements.
Posting internally from Oct 23-Oct 30
Responsibilities
- Establish and maintain positive relationships with patients, visitors, and other employees. Interacts professionally, courteously, and appropriately with patients, visitors and other employees. Behaves in a manner consistent with maintaining and furthering a positive public perception of BronxCare Health System and its employees.
- Contributes to and participates in the Performance/Quality Improvement activities of the assigned department. Contribution and participation includes data collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement (CQI) teams, consistent adherence to the specific rules and regulations of the BronxCare Health System (a) Safety and Security Policies, (b) Risk Management: Incident and Occurrence Reporting, (c) Infection Control Policies and Procedures and (d) Patient and Customer Service.
- Insures authorization requests are obtained and processed for medical and ancillary services on a timely basis and manage the accurate submission of authorization requests and the entry of authorization to Allscripts Clinical Registration System
- Responds in a timely manner to the pre-authorization, authorization and pre-certification requests of various points of service areas located within BronxCare Health System’s ambulatory practices.
- Retrieves and reviews patient utilization data to secure authorization for scheduled services. Updates BxCare practice administrative personnel and Care Providers regarding authorization decisions rendered by insurance carriers
- Navigates Allscripts EMR (Acute Care) and communicates with Practice Administrative staff or Care providers to retrieve required clinical utilization data to facilitate insurance carrier review and expeditious authorization approval
- Communicate on a daily basis with practice managers, clinicians and PFS staff to ensure that visits are appropriately registered, meet all insurance pre-authorization requirements and increase revenue by reducing payment denials for unauthorized services.
- Maintains accurate and complete reporting deliverables showing productivity and outstanding items to be addressed, conducts follow up on outstanding cases as needed.
- Act as a liaison with clinics, physicians, patients, staff, insurers and ancillary departments and maintain a positive relationship with all.
- Maintain the highest level of professionalism and confidentiality at all times to ensure compliance with Federal/State regulations such as HIPAA and EMTALA..
Qualifications
- Minimum Two (2) years’ experience of Hospital/Healthcare in Financial Investigations and/or Insurance Verification and/or Insurance Authorization
- Excellent Customer Service Skills
- High School or GED
- Associates
- Basic Computer knowledge
Job Summary
Full Time
Hospital
$57k-76k (estimate)
11/01/2023
10/30/2025
bronxcare.org
BRONX, NY
3,000 - 7,500
1890
$500M - $1B
Hospital
Related Companies
About BronxCare Health System
BronxCare is the largest voluntary, not-for-profit health and teaching hospital system serving the South and Central Bronx, with 859 beds and more than 4,500 employees. Its two main hospital divisions, comprehensive psychiatric and chemical dependency programs, long-term care facility, and extensive outpatient network are delivering the highest quality and accessible services to the community. BronxCare is now among the largest providers of outpatient services in New York City, with close to one million visits annually. Its ER is also responding to 141,000 visits, one of the busiest in New Yor...k. In 2017, BronxCare Health System received full accreditation from the Joint Commission, the leading accrediting authority for hospitals in the nation. Its medical school affiliation with the Icahn School of Medicine at Mount Sinai and Clinical Collaboration with the Mount Sinai Health System, as well as 16 accredited residency and fellowship programs, are strong indicators of excellence. BronxCares outpatient practices are also certified as a Level Three Patient-Centered Medical Home (the highest designation) by the National Center for Quality Assurance. As an engine for positive change, BronxCare has infused more than $300 million into the Bronx economy, including a 60,000 square foot BronxCare Health and Wellness Center for outpatient care, 56,000 square foot BronxCare Life Recovery Center for chemical dependency services, a brand-new 10,000 square foot state-of-the-art Cancer Care facility, and numerous capital projects.
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