Patient Access Representative

BRIEF DESCRIPTION :

The Representative helps assist the Phillips Family Cancer Center Team Lead and is responsible for multiple complex revenue cycle functions within the department. Keeps abreast of current insurance regulations and handles administrative support functions related to all departments under the division of Patient Access Services. Collaborates with nursing staff, non-clinical staff and other professional staff to assist in an efficacious process flow and to ensure adherence to regulatory and / or insurance contractual mandates. This position is responsible for maintaining and improving patient experience as well as providing high quality customer service to patients and colleagues.

RESPONSIBILITIES :

• Performs clerical duties for the Patient Access Services department that include typing, filing, copying, scanning, and other duties assigned.
• Maintains data integrity of various tracking spreadsheets.
• Works with Team Lead to uncover root causes of lost revenue.
• Reviews, evaluates, documents and tracks all private pay accounts; reaches out to patients for insurance and / or payment information.
• Checks Insurance Eligibility of all insured and self-pay patients.
• Initiates single-case agreements and obtains insurance referrals as needed.
• Obtains authorization / notification for elective and / or emergent services via the insurance payer website, facsimile, or phone.
• Provides cost estimation to all patients requesting services.
• Initiates and tracks all guarantee of payment agreements.
• Manages the completion of monthly ERMA forms for Emergency Medicaid patients.
• Stays abreast of changing third-party payer criterial to aid in revenue capture as it relates to the hospital's financial policy.
• Cooperates with the Patient Financial Service Office and Management to aid in proper reimbursement.
• Refers patient to Financial Team Lead for assistance with Medicaid application.
• Works closely with the Radiology Representative to cover radiology authorizations and scheduling functions when needed.
• Abides by documentation guidelines consistently.
• Promotes a positive and professional work environment, patient safety, and adheres to hospital policies.
• Performs other department-specific duties as deemed appropriate by Management.
• Adheres to all company and department policies and procedures in confidentiality, regulatory or contractual mandates and HR policy.

REQUIREMENTS / EXPERIENCE AND QUALIFICATIONS :

Special Notes :     Resume / CV should be included with the online application.

Prior to start date, the selected candidate must meet the following requirements :

Failure to comply with any of the above requirements could result in a delayed start date and / or revocation of the employment offer.

Company Overview :

Stony Brook Southampton Hospital as part of the Stony Brook Medicine provides direct access to the highest level of academic-based medical care. Located in the heart of the village of Southampton, two hours from New York City, the hospital provides healthcare services to a diverse community of year-round residents, second homeowners and vacationers. The population, about 75,000 in the winter months, increases sharply to more than 300,000 in the summer. Stony Brook Southampton Hospital has been recognized as a Long Island Top Workplace by  Newsday among large employers (defined as having 500 employees).

StaffCo is a Professional Employer Organization, commonly referred to as a PEO. StaffCo and SUNY have entered into a professional employer agreement under which StaffCo is the employer of Stony Brook Southampton employees and responsible for employment, including the day-to-day direction and supervision of work.StaffCo is fully responsible for providing all Payroll and Human Resource services, including the payment of wages, collecting and reporting payroll taxes and maintaining any and all benefits for which one is eligible.  SUNY Stony Brook Hospital is responsible for the operation of the hospital and provision of health care and is the co-employer as is necessary to conduct its responsibilities and for related licensure, regulatory or statutory requirements and obligations.

Given StaffCo’s employment responsibilities, it is deemed the “employer” for employment and labor law purposes.  Thus, the employees are private sector employees of StaffCo, not public sector employees of SUNY.  The private sector nature of the StaffCo employees has been approved by NYS Civil Service and upheld in a decision by the US National Labor Relations Board.