At Stony Brook Medicine, our Patient Access Representatives are responsible for completing varied, diverse and specialized duties to support the Revenue Cycle, Compliance and Patient Experience by accurately and efficiently completing tasks in areas of Registration, Financial Screening and Verification, and patient throughput. Qualified candidates will demonstrate excellent communication skills, interpersonal skills, knowledge and understanding of patient care and effectively respond to changing patient needs by making decisions based on ethical principles and adhering to our high standard of excellence.
The Patient Access, Financial Clearance Representative is responsible for providing financial clearance, guidance and excellence in financial care to our patients and their representatives by performing daily tasks aimed at validating patient insurance / benefit information while securing proper notification and/or authorization for a patient admission, test and/or procedure.
Duties of a Patient Access Financial Clearance Representative may include the following, but are not limited to:
For all in scope surgical and outpatient services, ensure a patient's visit is financially secured by performing complete financial verification processes, including but not limited to; confirming all patient coverage, validating hospital participation, securing benefit information, authorizations, and/or referrals.
Ensure notifications are communicated to the insurance carrier for all non-scheduled services (Inpatient admissions and observation status) and collaborate with Care Management on authorization follow up requirements.
Maintains competency in policy benefit and nuisances, actively utilizes insurance web sites and other tools to ensure financial verification.
Accurately inform patients of all coverage, benefits and financial obligation benefits (including deductibles, copay / co-insurance, Out of Network benefits (if applicable), and out of pocket maximums). Refer patients to Financial Assistance Services, when appropriate.
Follow up on Emergency treat and release encounters that require financial clearance and/or further investigation.
Supports the onsite registration areas with financial services expertise.
Qualifications
Required:
Associate's degree with 1 year of work experience in financial services, public health, healthcare or related industry such as insurance.
In lieu of degree, 2 years of demonstrated excellence working in financial services, public health, healthcare, or related industry.
Excellence in verbal and written communication, computing and multi-tasking skills.
Candidate must demonstrate experience and expertise in speaking with customers and can work well with persons who are under stress (such as sick patients and distressed family members).
Strong PC experience and Microsoft Office: Excel, PowerPoint, and Word.
Ability to work with multidisciplinary teams.
Preferred:
Bilingual in English and Spanish.
Billing experience, Accounts Receivable, Hospital Patient Access / Registration experience.
Familiarity with Medical insurance benefits, demonstrated through experience with EMR computerized registration / Financial / IT systems.
Knowledge of medical terminology.
Previous experience
