NYC Health + Hospitals/Carter is a state-of-the-art facility with a 4-Star CMS Quality Rating, equipped with 164-bed Skilled Nursing Facility and 201-bed Long-Term Acute Care Hospital (LTACH) based in Harlem. Carter excels at providing quality medical, sub-acute, rehabilitative, and long-term specialty services for individuals in need of medically-complex care like ventilator weaning and onsite-dialysis. Every employee takes a person-centered approach that exemplifies our ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnership.

From more than 600 Nursing Homes in New York, Carter ranks #4 in Newsweek’s Best Nursing Homes in New York2026; and also received a high-performance rating for Long-Term Care and Short-term Rehabilitation from U.S. News & World Report’s Best Nursing Homes in America 2026. In 2025, Carter was awarded the American Nurses Credentialing Center’s Pathway to Excellence with Distinction Award, the nation’s first long-term facility to receive it.

At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.

9:00 A.M – 5:00 P.M

Position Overview:

Under general supervision of the Director, assists in planning, organizing and supervising the functions and day-to-day activities of Financial Eligibility determination as relating to financial investigation and/or billing and collection sections. Participates in implementation of policies, systems and procedures relating to staffing, supervision of personnel, coordination, control, audit and review of required activities to maximize collection of in-patient and outpatient billings, in accordance with policies and procedures established by the Corporation including preparation for billing, follow-up of collection cycle procedures, and maintenance of documentation flow for reimbursement. Streamlining processes for submission of new and conversion applications utilizing software for electronic transmission while ensuring their effectiveness, proficiency and productivity. Serves as principal assistant to Director of Patients Accounts Eligibility division and assumes full responsibility and authority in his/her absence.

Span of Control: 5 staff ( Hospital Care Investigators)

Responsibilities:

• Managed and supervised of five Nursing Homes (Post-Acute Care Facilities) and Long-Term Acute Care Specialty Hospital, bed capacity of approximate 2,035 beds.
• Supervised eighteen staff ensuring the implementation of policies and procedures of the Corporation, NYSDOH and Patient Account Department
• Wrote, customized and implemented Standard Work for Post-Acute Facilities
• Collaborated with MAPSng (Electronic Portal for Medicaid application submission) and HRA in trouble shooting problems cases for the Post-Acute Facilities
• Review all new and re-admit admission record received from centralized admission and screen for Long term, short term cases in addition to verification and confirmation of insurance coverage and send out email blast to all appropriate parties on updates needed with attending weekly UR meeting to discuss residents needing Medicaid insurance coverage.
• Manages census and payer tree management in Point Click Care and EPIC system and validate for accuracy
• Reviewing various PCC and EPIC reports applicable to eligibility and reporting any changes to the billing staff
• Follow up on cases to ensure Medicaid submission are within 60 days and send email to HCI for submission or follow up on documentation needed.
• Notify resident or responsible party of approved Medicaid with their monthly NAMI (Net Available Monthly Income) responsibility and encourage to sign up for RFMS electronic NAMI withdrawal
• Transmit Nursing home roster received from DOH into Excel format, compare with prior month roster for any changes in insurance plan, and send findings to eligibility and billing staff and Managed Care coordinators to obtain custodial authorization.
• Assess, collect paperwork, prepare Guardianship Referral for submission to Corporation Counsel, sign Guardianship Petition, and attend guardianship court hearing and monitor progress
• Assessment along with Social Work Department cases that lack citizenship documentation for NYLAG referral
• Educated staff and Post-Acute Care population on the Medicaid and Managed Care process according to DOH and HRA guidelines in order that the Post-Acute Care Facilities remain in compliance.
• Request self-pay bill for residents who are ineligible for Nursing Home Medicaid due to excess resources and request comprehensive bills to be sent to the Public Administration on decease residents
• Communicate expectation with HCI staff, address deficiencies and assist in maintaining and increasing Medicaid eligibility
• Training new staff member on eligibility functions, sign off on timesheets and monthly time and grant reports and complete Human Resources employee evaluations
• Review and sign off on monthly time and grant report and submit to respective team
• Coordinate and review work of subordinates relating to assigned tasks;
• Monitored the operations and efficiency of the office;

1.Bachelor’s degree from an accredited college or university in Accounting, Finance, Business Administration, Hospitality Management or a related discipline; and 2.Three (3) years of experience in accounting, finance or business administration; one (1) year of which must have been in a responsible supervisory or managerial capacity managing accounts or credits.

General knowledge of policies and program utilized in the operation of health care facility ability to assimilate and analyze data, to recommend action based on analytical findings, and to assist in the solution of complex problems in health care administration and management. Ability to analyze a problem or situation and make appropriate judgments, such a logical conclusion, feasible solution or most appropriate action. Be cognizant of all HIPPA privacy rules to PHI. Proficiency in Microsoft Excel and Word and maintains statistical records and prepares status reports

NYC Health and Hospitals offers a competitive benefits package that includes:

• Comprehensive Health Benefits for employees hired to work 20+ hrs. per week
• Retirement Savings and Pension Plans
• Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts
• Loan Forgiveness Programs for eligible employees
• College tuition discounts and professional development opportunities
• College Savings Program
• Union Benefits for eligible titles
• Multiple employee discounts programs
• Commuter Benefits Programs

If you wish to apply for this position, please apply online by clicking the "Apply for Job" button.