Healthcare Billing Investigator - NYCSOCW

Job Title: Healthcare Billing Investigator

Duties:

• Review and process patient accounts, ensuring claims are accurately completed for timely submission.
• Resolve billing edits, denials, and rejections by collaborating with payers and internal departments.
• Post payments, adjustments, and refunds to patient accounts and maintain detailed documentation.
• Handle pre-authorizations and follow up on outstanding claims or balances.
• Generate aging reports for patient and insurance balances, addressing overdue accounts appropriately.
• Provide excellent customer service to patients, including arranging payment schedules.
• Refer escalated cases to supervisors as necessary and participate in relevant training sessions.

Skills Required:

• Proficient in paper and electronic claim processing, database systems, and patient account audits.
• Strong communication and problem-solving skills.

Education:

• Bachelor’s Degree preferred or equivalent combination of education and experience (minimum High School diploma with 4+ years of related experience).