Credit&Coll Ana-Hospital
: Job Details :

Distinguishing Features of the Class:

Under general supervision, incumbents are responsible for interviewing patients and/or their relatives to evaluate medical coverage for payment of treatment and determine payment/reimbursement methods to Westchester Medical Center. This includes coordinating with other divisions to verify hospitalization details, diagnosis, and services rendered to determine costs. The role involves establishing relationships with providers such as Blue Cross/Blue Shield, Workers' Compensation, private insurance, Medicare, and Medicaid to verify coverage eligibility, reimbursement portions, and follow-up procedures for third-party billing. Supervision may be exercised over lower-level clerical staff. Performs related work as required.

Examples of Work:

Required Knowledge, Skills, Abilities, and Attributes:

• Knowledge of various medical coverage options, payment methods, and coverage limitations.
• Understanding of billing and collection practices from third-party agencies.
• Familiarity with hospital admitting, medical records, and utilization review functions related to reimbursement.
• Skill in arithmetic calculations.
• Ability to interview patients and families to extract coverage information.
• Ability to plan and follow up on payment schedules.
• Ability to establish effective working relations with hospital divisions and third-party agencies.
• Proficiency in computer applications such as spreadsheets, word processing, email, and databases.
• Effective communication skills in English.
• Good judgment, tact, initiative, resourcefulness.
• Physical condition suitable for the position's requirements.

Minimum Education and Experience:

High school diploma or equivalency plus four years of experience in credit and collection, billing, loans, insurance, or similar work, with at least two years in a hospital patient accounts unit. Substitutions include 30 college credits per year of experience (up to two years) or experience liaising with managed care agencies involving referrals, precertifications, and authorizations (up to two years). Education must be from an accredited post-secondary institution recognized by the NYS Board of Regents.

About Us:

Westchester Medical Center is the leading provider of advanced medical care in New York's Hudson Valley, serving as a primary referral hospital for over 3 million residents with services including trauma, organ transplants, and neurovascular procedures. Located in Valhalla, NY, it is part of the Westchester Medical Center Health Network.