Long Island Community Hospital has served this richly diverse region as a patient-first community hospital for more than 60 years. As Long Island's only independent community hospital, we are 100% committed to becoming the community's healthcare provider of choice with our greatly enhanced services including the Knapp Cardiac Care Center, our highly-advanced heart disease diagnosis and treatment facility, our new modern surgical pavilion, our unique ER approach, and our high-touch services including women's imaging, sleep laboratory and orthopedics and more. These services are delivered with the highest level of compassion by our LI Community Hospital staff - Long Islanders with an unmistakable mix of courage and heart who care about the people right here in our community and whose sole purpose is to provide personalized comfort. For more information, go to licommunityhospital.org, and interact with us on LinkedIn, Glassdoor, Indeed, Facebook, Twitter, YouTube and Instagram.
Qualified candidates must be able to effectively communicate with all levels of the organization.
Long Island Community Hospital provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.
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Long Island Community Hospital is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online.
If you wish to view Long Island Community Hospital's EEO policies, please click here. Please click here to view the Federal "EEO is the law" poster or visit https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm for more information.
Required Skills
Job Responsibilities:
- Checks all inpatient Medicaid/County bills for accuracy in Epremis System prior to submission on a daily basis.
- Write up County vouchers and send to County with UB04 claim.
- Check all inpatient Workers Compensation/No Fault bills for accuracy in Epremis system prior to submission on a daily basis.
- Utilizes patient information screens and checks notes for special billing Instructions prior to submission.
- Review daily reports to request medical records for workers compensation/no fault cases via Stockamp Quic Lists.
- Prepares inpatient Medicaid/Workers Compensation/No Fault claims for electronic and paper claims submission on a daily basis.
- Makes sure all claims are accompanied by any applicable authorizations/precerts/referrals and medical records.
- Review the Stockamp Quic lists — for new Medicaid, Workers Compensation and No Fault cases, load the appropriate insurance plan codes and performs a rebill function in FMS. For Medicaid cases-verify the Medicaid coverage via EMEVS or Epaces prior to loading the Medicaid plan and performing the rebill function.
- Performs various billing projects assigned by supervisor.
- Checks all outpatient Medicaid/County bills for accuracy in Epremis system prior to submission on a daily basis.
- Write up County Vouchers and send to County with UB04 claim.
- Utilizes patient information screens and checks notes for special billing instructions prior to submission.
- Corrects account information for accounts that appear on the error reports and performs rebills.
- Prepares Medicaid claims for electronic submission on a daily basis.
- Make sure all claims are accompanied by any applicable authorizations/precerts/referrals.
- Reviews the Stockamp Quic list — for new Medicaid cases, loads the Medicaid insurance plan and performs a rebill function in FMS.
- Reviews Stockamp STAT list for Inpatient Medicaid cases. Checks claim status on Epaces, and place notes in FMS. If claim denied perform rebill to Medicaid if needed.
- Reviews Stockamp STAT lists for Inpatient Workers Compensation/NoFault cases.
- If accounts require follow up, contact various carriers via phone for claim status (i.e. CSC, Out of State Medicaid carriers, County, WC and NF Carriers)
- If any necessary changes are required; makes the changes to the claim and Epremis and re-submits the corrected claim either electronically or via mail.
- Brings problems accounts to the immediate attention of Governmental Coordinator or Supervisor.
- Reviews Stockamp STAT lists for Out-patient Medicaid cases. Checks claims status on Epaces and place notes in FMS. If claim denied perform rebill to Medicaid if needed.
- If accounts require follow up, contacts various carriers via phone for claim status (i.e.CSC, out of state Medicaid carriers, County)
- If any necessary changes are required: makes the changes to claim in Epremis and re-submit the corrected claim either electronically or via mail.
- Brings problem accounts to the immediate attention of Governmental Coordinator or Supervisor
- Updates all accounts with referral date for future follow up on a daily basis, in Stockamp STAT lists.
- If a denial is identified, immediately enters denial reason as a comment in FMS, moves the balances to appropriate payor and changes the financial class. Moves account to appropriate Stockamp STAT list.
- Enters 7M record in FMS to show current status of claim as a result of follow up (i.e. insurance rep name, approximate date of expected reimbursement)
- Performs other duties as indicated by Supervisor.
- Any correspondence received for Inpatient Medicaid, Workers Compensation No Fault gets reviewed. Information to be noted as 7M message in EMS, Account to be followed up with phone call to insurance carrier.
- Refers difficult or problematic correspondence to Governmental Coordinator Or Supervisor.
- Any correspondence received for outpatient Medicaid gets reviewed, information to be noted as 7M message in EMS, account to be followed up with phone call to carrier.
- Refers difficult or problematic correspondence to Governmental Coordinator or Supervisor.
- Once an inlier payment received from carrier — and accounts have been qualified for additional cost outlier monies, requests the medical records and copies all info from imaging (UB04, itemized bills, copy of EOB, medical records and cover sheet and places in Vendor box) contacts vendor that a pick up is needed.
- Handles mail from IPRO regarding cost outlier review — identifies encounter # and copies IPRO letter and faxes letter to vendor handling the cost outlier billing.
Required Experience
Minimum Qualifications:
- To qualify you must have a High school diploma or equivalent
- Ability to use Microsoft Windows/ work in a Windows Environment
- Good organizational and analytical skills
- Must have the ability to concentrate and be detail oriented
- Ability to interpret reports and function in highly computerized environment
- Interpersonal and communication skills to interact with various personnel, insurance carriers, patients and agencies in both written and oral forms
- Ability to work independently and complete tasks and projects accurately and timely
- Ability to operate calculator and various office equipment
- Flexible to perform multiple tasks
- Knowledge of Medicaid, Workers Compensation and No fault Facility Billing preferred.
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