Patient Access Representative, Financial Clearance

Position Summary

The Patient Access Representative Financial Clearance supporting pre-registration services located in Commack NY is a key member of the Patient Access Services team. Acts as quality control for inpatient elective accounts outpatient surgeries and ancillary hospital services ensuring all pertinent demographic and insurance information is identified and accurately documented supporting timely and efficient billing. Secures financial clearance through insurance verification and authorization/referral validation. Communicates with multiple clinical and operational departments ensuring documentation of third-party review registrations are complete and meet financial clearance criteria prior to the registration areas with financial services expertise.

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 and 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.

Duties of a Patient Access Financial Clearance Representativemay include but are not limited to the following:

• Follows policy and procedure in regard to financial screening investigation referral authorization requirements and patient cost sharing for all scheduled hospital elective services.
• Verifies and assures all insurance coverage is active and confirms eligibility and benefits for specific service validates proper authorization is secured for appropriate procedure diagnoses and service location. Clearly documents notes regarding financial clearance process.
• Serves as support to patients and their family members to assure patients have access to all available financial assistance resources.
• Maintains daily contact with Utilization Management Business office patient registration ancillary departments as well as physician offices to ensure all registration information is accurate and financial clearance requirements are met prior to scheduled elective services.
• Contacts referring/ordering provider in a timely manner to initiate or complete payor requirements to secure authorization approval prior to scheduled procedure.
• Utilizes computer systems/software used by the registration/scheduling department and maintains competence in policy benefit and nuisances actively utilizes insurance web sites and other communication with insurers as required to ensure payment and patient financial care.
  

• Provides financial guidance and excellence in Financial Care to patients and their representatives by providing information about their health care insurance coverage and cost share responsibilities.

  
  

• Ensures compliance with HIPAA regulations payor guidelines and healthcare industry standards.
• Utilizing various work lists monitor and ensure registration workflow and financial clearance process is complete within prescribed time frames.

• Demonstrates a positive organizational attitude and commitment to patient experience. Maintains respectful and compassionate demeanor and provides high-quality patient centered care.

The selected candidate will be required to work some holidays.

Qualifications

Required:

• A minimum of an Associates degree and at least 1 year of experience working in a hospital physician practice or healthcare setting in revenue cycle patient access financial counseling or insurance authorizations.
  or in lieu of degree at least 2 years of demonstrated experience in revenue cycle patient access financial counseling or insurance authorizations.
• Strong background in medical insurance verification benefits investigation and authorization management.
• Extensive knowledge of commercial insurance Medicare Medicaid managed care plans workers compensation and government-funded insurance programs.
• Skilled in interpreting insurance benefits medical necessity requirements and payer-specific policies.
• Experience with electronic health records (EHR) practice management software and insurance portals.
• Knowledge of CPT ICD-10 and HCPCS coding related to authorization and insurance verification.
• Excellent analytical organizational and customer service skills with the ability to manage high-volume workloads while maintaining accuracy.
• Proven ability to resolve complex insurance issues reduce authorization turnaround times and improve reimbursement outcomes.

• Billing experience and an understanding of Accounts Receivables.
• Previous experience as a Patient Access Representative in a medical center or hospital preferred.

Please Note: Verification of degree (e.g. diploma or official transcript) is required for this role. Upload of documentation must be included with your application for consideration.

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 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 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 may be 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 datethe selected candidate must meet the following requirements:

• Successfully complete pre-employment physical examination and obtain medical clearance from Stony Brook Medicines Employee Health Services*
• Complete electronic reference check with a minimum of three (3) professional references.
• Successfully complete a 4panel 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 workingenvironment. 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 .

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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 salary range (or hiring range) for this position is $54175 - $61010 / year.

The above salary range represents SBUHs good faith and reasonable estimate of the range of possible compensation at the time of posting. The specific salary offer will be based on the candidates validated years of comparable efforts to inflate or misrepresent experience are grounds for disqualification from the application process or termination of employment if hired.

Some positions offer annual supplemental pay such as:

• Location pay for UUP for full-time positions ($4000).

Your total compensation goes beyond the number in your paycheck. SBUH provides generous leave health plans and a state pension that add to your bottom line.