Third Party Audits Coordinator
About the job
- Three to five years of collection experience.
- Knowledge of Medicare and Medicaid reimbursement processing is preferred.
- Experience maintaining patient file information.
- Experience with billing information systems.
- Experience in a health care environment is preferred.
- Strong verbal and written communication skills.
- Good analytical skills.
- Ability to multitask and willingness to learn new skills.
- Ability to deal effectively with multiple information sources.
- Research patient accounts related to audits and activity from third-party payers and internal audits within the required timeframe.
- Identify and report root causes for audit recoveries by third-party payers and recommend or participate in corrective actions for BronxCare Health System and MLK.
- Contribute to and participate in the assigned department's performance and quality improvement activities, including data collection, analysis, implementation of and compliance with risk management and claims activities, and participation in Continuous Quality Improvement teams.
- Adhere to BronxCare Health System safety and security policies, risk management incident and occurrence reporting, infection control policies and procedures, and patient and customer service requirements.
- Communicate with third-party payers and internal parties to obtain required information and complete assignments within the required timeframe.
- Ensure compliance with billing requirements and timely follow-up for all assigned accounts.
- Use information systems to retrieve and verify information and appeal denied cases in payer web portals as appropriate.
- Obtain medical records for claims denied by payers requesting clinical information, and submit records to the payer as required.
- Review and obtain utilization management status and any recorded actions.
- Knowledge of Medicare and Medicaid reimbursement processing.
- Experience in a health care environment.
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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