Patient Access Representative - Patient Access Financial Services - Includes Weekend Hours

Position Summary

At Stony Brook Medicine, our Patient Access Representatives are responsible for completing varied, diverse and specialized goal oriented Patient Access duties support the Revenue Cycle, Compliance and Patient Experience completing varied, complex and specialized functions in areas of Registration, Financial Screening and Verification, 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.

Duties of a Patient Access Representative may include the following but are not limited to:

• Coordinates and supports activities to ensure excellence in throughput for inpatient and observation patients. This will include same day admissions, urgent, emergency, and transfers.
• Responsible for review and ensure correct coding of patient types, medical services to support billing and revenue cycle goals to include patient status changes.
• Follow appropriate patient placement utilizing the facilities bed allocation.
• Completes and files death certificates with Brookhaven Town and Department of Health.
• Determines eligibility and patient cost share (co-pay / deposit etc.) using electronic systems and other means, taking payments at point of service.
• Determines and communicates to each patient/patient representative, confirming how the encounter will be paid, and properly assist in screening self-pay patients to determine Medicaid or Charity Care options, referring to a Financial Counselor when appropriate.
• Ensures that compliance regulations are met (including ensuring securing consents and r egulatory signatures from patients or designee, essential for treatment and payment, as per procedure).
• Maintains and requires appropriate documents as necessary (i.e. copies of photo ID and insurance documents etc. Witnessing general consents, agreements, and acknowledgements.
• Provides financial guidance and excellence in Financial Care to patients and their representatives including information about their health care insurance coverage, cost share responsibilities and for self-pay patients, qualification for Medicaid and / or the financial assistance working to ensure complete applications for Medicaid and/or Financial Aid applications. Provides Medicaid/ Marketplace (Affordable Healthcare Act) counseling as appropriate.
• Assists and instructs staff as well as clients on issues related to insurance verification of authorizations and referrals. Reviews registrations for completeness and correctness, supports the registration areas with financial services expertise.
• Collect co-pays, deposits and deductibles at time of registration/admission.
• Monitors staff productivity and provide constructive feedback to staff with management guidance.
• Train and in-service new and continuing employees on a continuing basis.

The selected candidate will be required to work some holidays. On the weeks that the selected candidate is scheduled to work the weekend, they be assigned to split pass days of Tuesdays and Fridays. The schedule/pass days are subject to change.

Essential Position: This function/position has been designated as "essential." This means that when the Hospital is faced with an institutional emergency ( staff shortages, increased census, inclement weather, and/or other emergencies) , 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.

Qualifications

Required Qualifications: Associate's Degree with one year working experience in a financial services, public health, health, or related industry such as insurance. In lieu of degree, two years of demonstrated excellence working in a financial services, public health, health, or related industry such as banking or insurance (or other related industry requiring similar skills) which demonstrates comparable complex skill experience in payment collection, insurance reimbursement, access services etc. Demonstrated 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 their distressed family members).

Preferred Qualifications: Bilingual in English and Spanish. Billing Experience, Accounts Receivable, Banking Hospital Patient Access/Registration experience, Familiarity with medical insurance benefits, Bed Control Management, demonstrated 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.