Patient Access Services, Representative - Cancer Services

Patient Access Services Representative – Cancer Services

Stony Brook Southampton Hospital’s Patient Access Services collaborates across departments to ensure timely authorization for elective and emergent procedures, manage insurance verification, and provide high‑quality customer service to patients and colleagues. This role maintains compliance with regulatory agencies, safeguards patient safety through accurate identification, and supports the hospital’s revenue cycle.

• Perform scheduling/registration functions and general office duties including word processing, copying, filing, faxing, answering phones, and data entry.
• Verify insurance eligibility of all insured and self‑pay patients.
• Obtain and verify authorization/notification for elective and emergent services via insurance payer website, facsimile, or phone.
• Review, assess, and evaluate patient registrations to ensure accuracy of demographic and financial information.
• Maintain add‑on authorization and eligibility services.
• Collaborate with physician offices and third‑party payers concerning authorizations and eligibility.
• Verify co‑payment, deductible, co‑insurance, and out‑of‑network amounts according to patient’s health insurance plan and contractual agreement.
• Refer self‑pay patients to financial aid/self‑pay representative.
• Demonstrate advanced critical thinking skills to navigate ambiguous patient scenarios.
• Maintain data integrity of various tracking spreadsheets.
• Manage completion of monthly ERMA forms for Emergency Medicaid patients.
• Maintain current knowledge base regarding insurance information and managed care guidelines; maintain knowledge base of designated networks based on managed care contracts.
• Collaborate with other departments to ensure the needs of the patient and department are met.
• Utilize data retrieval and insurance eligibility systems.
• Develop and maintain positive customer service with patients, colleagues, visitors, and vendors by exercising diplomacy and tact.
• Manage RQA reports by resolving errors and producing corrected accounts.
• Abide by documentation guidelines consistently.
• Adhere to all company and department policies and procedures, confidentiality or regulatory or contractual mandates, and HR policy.
• Practice confidentiality and privacy protocols in accordance with hospital policies and HIPAA requirements.
• Comply with departmental dress code and maintain a neat appearance.
• Keep current with departmental and hospital training requirements, including annual refresher courses.
• Perform other department‑specific duties as deemed appropriate by Patient Access Leadership.

• High School Diploma/GED and two (2) years’ experience in Revenue Cycle, Medical Office, or Business Office.
• One (1) year direct Patient Access experience.
• One (1) year direct insurance verification/authorization experience.
• Customer service and support skills.
• Quantitative/analytical skills and computer savviness including Microsoft Office, Word, Excel, PowerPoint, and knowledge of external provider web portals.
• Exceptional attention to detail and accuracy in all tasks, ensuring high quality results and minimizing errors.
• Ability to multitask in a high‑stress, fast‑paced environment.
• Capability to work independently with minimal supervision, demonstrating strong self‑motivation and initiative with strong time‑management skills to meet deadlines.
• Comprehensive knowledge to help patients understand medical insurance benefits.

• Associate’s degree strongly preferred.
• Experience with CPT, ICD‑10, and medical terminology strongly preferred.

• Prolonged periods of standing, walking, and sitting.
• Commuting to hospital and offsite facilities required.
• Must be able to lift up to 25 pounds.
• Possibl…