Financial Investigator
About the job
- At least two years of hospital or healthcare experience in financial investigations, insurance verification, or insurance authorization.
- Excellent customer service skills.
- High school diploma or GED.
- Associate degree.
- Basic computer knowledge.
- Establish and maintain positive relationships with patients, visitors, and employees, interacting professionally and courteously and supporting a positive public perception of BronxCare Health System.
- Participate in departmental performance and quality-improvement activities, including data collection and analysis, implementation of and compliance with risk-management and claims activities, participation in Continuous Quality Improvement teams, and adherence to safety and security, incident reporting, infection control, and patient and customer service policies.
- Obtain and process authorization requests for medical and ancillary services on time, accurately submit requests, and enter authorizations into the Allscripts Clinical Registration System.
- Respond in a timely manner to pre-authorization, authorization, and pre-certification requests from service areas in BronxCare Health System ambulatory practices.
- Retrieve and review patient utilization data to obtain authorization for scheduled services, and update practice administrative personnel and care providers about insurance-carrier authorization decisions.
- Navigate Allscripts EMR (Acute Care) and communicate with practice administrative staff or care providers to retrieve clinical utilization data needed for insurance-carrier review and timely authorization approval.
- Communicate daily with practice managers, clinicians, and PFS staff to ensure visits are appropriately registered and meet insurance pre-authorization requirements, and to reduce payment denials for unauthorized services.
- Maintain accurate productivity and outstanding-item reports and follow up on outstanding cases as needed.
- Act as a liaison among clinics, physicians, patients, staff, insurers, and ancillary departments while maintaining positive relationships.
- Maintain professionalism and confidentiality and comply with applicable federal and state regulations, including HIPAA and EMTALA.
About the company
BronxCare Health System is a nonprofit teaching hospital network serving the South and Central Bronx in New York City. Its Grand Concourse hospital provides emergency, inpatient and specialty care, while the Fulton Avenue site offers psychiatric and addiction treatment alongside a nursing home. Neighborhood practices provide primary and outpatient care, and the system bills patients and their health plans for clinical services. It trains physicians through accredited residency programs and maintains medical school and clinical affiliations with Mount Sinai. With hospital origins dating to 1890, BronxCare is headquartered at 1650 Grand Concourse in the Bronx.
Company Size
1,001-5,000
Company Stage
N/A
Total Funding
N/A
Headquarters
New York City, New York
Founded
1890
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Simplify's Take
What believers are saying
- New York granted BronxCare a $966,667 community HIV primary-care contract through June 2028.
- UHF selected BronxCare for a 2026 chronic-disease collaborative funded by Mother Cabrini.
- American Lung Association named BronxCare a Bronx partner for its 2026 clean-air initiative.
What critics are saying
- Malpractice litigation persists, including 2025 Jackson and 2025 Dixon cases against BronxCare.
- Headcount fell to 3,180 in March 2026, while openings dropped to six.
- Dependence on public grants and Medicaid-like reimbursement pressures margins if volumes soften.
What makes BronxCare Health System unique
- Mount Sinai collaboration expands specialty access across cardiology, oncology, surgery, orthopaedics, pediatrics.
- BronxCare holds 2026 heart, stroke, emergency, and patient-centered medical home recognitions.
- CMS Million Hearts model and NCQA recognition reinforce BronxCare's chronic-care management capabilities.
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