Position Summary 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 Lead Financial Clearance Representative will perform daily tasks aimed at validating patient insurance / benefit information while securing proper notification and/or authorization for a patient admission, test and/or procedure. The Patient Access, Lead Financial Clearance Representative is responsible for providing financial clearance, guidance and excellence in financial care to our patients and their representatives. The Lead representative will serve as Financial Clearance team super user and will work with the Supervisor to ensure productivity and quality standards are met consistently. Concurrently assists with timely completion of Hospital and Cancer Center Financial Clearance tasks. Duties of a Lead Patient Access Financial Clearance Representative may include the following, but are not limited to:
- Assists Supervisor in evaluating patient Financial Clearance issues; responsible for communicating resolution steps or changes in work effort to appropriate staff.
- Work directly with staff to ensure workflow consistency and provide positive guidance and direction to staff on matters of Financial Clearance protocols and process flows.
- Identifies and communicates staff development needs to Supervisor and provides training or re-education support.
- Utilize worklists, reports, dedicated mailboxes and other resources to monitor productivity and registration quality. Adjust staff assignments to meet changing demands.
- 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 and benefit nuances, revising job aids and reference guides as needed. Actively utilize insurance websites 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 treatment and release encounters that require financial clearance and/or further investigation.
- Supports the onsite registration areas with financial services expertise.
- Demonstrates a positive organizational attitude and commitment to patient experience. Maintains respectful and compassionate demeanor and provides high-quality patient centered care.
QualificationsRequired:
- Associate's degree with 1 year of experience in financial services, healthcare or related industry, such as insurance.
- In lieu of degree, 3 years of demonstrated excellence in financial services, 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 skills required.
- 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 as a Patient Access Representative at a medical center is preferred.
Special Notes:Resume/CV should be included with the online application. Posting Overview:This position will remain posted until filled or for a maximum of 90 days. An initial review of all applicants will occur two weeks from the posting date. Candidates are advised on the application that for full consideration, applications must be received before the initial review date (which is within two weeks of the posting date). If within the initial review no candidate was selected to fill the position posted, additional applications will be considered for the posted position; however, the posting will close once a finalist is identified, and at minimal, two weeks after the initial posting date. Please note, that if no candidate were identified and hired within 90 days from initial posting, the posting would close for review, and possibly reposted at a later date.
- Stony Brook Medicine is a smoke free environment. Smoking is strictly prohibited anywhere on campus, including parking lots and outdoor areas on the premises.
- All Hospital positions may be subject to changes in pass days and shifts as necessary.
- This position may require the wearing of respiratory protection, which may prohibit the wearing of facial hair.
- This function/position maybe designated as essential. This means that when the Hospital is faced with an institutional emergency, employees in such positions may be required to remain at their work location or to report to work to protect, recover, and continue operations at Stony Brook Medicine, Stony Brook University Hospital and related facilities.
Prior to start date, the selected candidate must meet the following requirements: - Successfully complete pre-employment physical examination and obtain medical clearance from Stony Brook Medicine's Employee Health Services*
- Complete electronic reference check with a minimum of three (3) professional references.
- Successfully complete a 4-panel drug screen*
- Meet Regulatory Requirements for pre-employment screenings.
- Provide a copy of any required New York State license(s)/certificate(s).
Failure to comply with any of the above requirements could result in a delayed start date and/or revocation of the employment offer. *The hiring department will be responsible for any fee incurred for examination. Stony Brook University is committed to excellence in diversity and the creation of an inclusive learning and working environment. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, pregnancy, familial status, sexual orientation, gender identity or expression, age, disability, genetic information, veteran status and all other protected classes under federal or state laws.
If you need a disability-related accommodation, please call the University Office of Equity and Access at (631)###-####. In accordance with the Title II Crime Awareness and Security Act a copy of our crime statistics can be viewedhere. Visit ourWHY WORK HERE page to learn about the total rewards we offer. Stony Brook University Hospital, consistent with our shared core values and our intent to achieve excellence, remains dedicated to supporting healthier and more resilient communities, both locally and globally.
Anticipated Pay Range: The starting salary for this position has been established as - $49,571 / year. The above salary range (or hiring range) represents SBUH's good faith and reasonable estimate of the range of possible compensation at the time of posting. In addition, all UUP positions have an additional $3,087 for location, Your total compensation goes beyond the number in your paycheck. SBUH provides generous leave, health plans, and state pension that add to your bottom line.