Patient Access: Financial Clearance Specialist

Stony Brook University; Commack (NY); On-site; USD 54,000 - 61,000; Full time

Benefits offered by this job

Location pay $4,000

Health plans

Generous leave

Job summary

Stony Brook University in Commack, NY seeks a Patient Access Representative, Financial Clearance to verify insurance, obtain authorizations, and ensure accurate registration for elective services. The role supports the Revenue Cycle and patient experience with strong communication and knowledge of payer policies.

The position requires an Associate's degree or equivalent experience in healthcare revenue cycle, with familiarity in CPT/ICD-10 coding and HIPAA compliance.

Qualifications

• Minimum Associate's degree and at least 1 year of experience 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.
• Experience with CPT, ICD-10, and HCPCS coding related to authorization and insurance verification.

Responsibilities

• 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.
• 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.

Education

Associate's degree

Job description

Stony Brook University in Commack, NY seeks a Patient Access Representative, Financial Clearance to verify insurance, obtain authorizations, and ensure accurate registration for elective services. The role supports the Revenue Cycle and patient experience with strong communication and knowledge of payer policies.

The position requires an Associate's degree or equivalent experience in healthcare revenue cycle, with familiarity in CPT/ICD-10 coding and HIPAA compliance.