Patient Access Services, Associate - Communications / Switchboard, Evenings

Stony Brook Southampton Hospital's Patient Access Services in a hospital setting encompasses many different roles and responsibilities. It is one of the most important and concentrated areas in healthcare. We are responsible for the delivery of the critical components of the revenue cycle, as well as keeping the hospital compliant with the many regulatory agencies, maintaining patient safety through correct patient identification practices and providing extraordinary customer service skills in situations that are often difficult.

POSITION SUMMARY:

The Patient Access Communications/Switchboard Associate is responsible for ensuring all patients are registered in accordance to departmental policy and procedure. 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 contractual mandates.

JOB DUTIES & ESSENTIAL FUNCTIONS:

• Supports registration functions and general office duties including word processing, copying, filing, faxing, answering phones and data entry.
• Conducts patient interviews as part of the scheduling/registration procedure, where they gather and confirm patient’s demographic details, insurance data, and financial obligations.
• Verifies patient’s prescription, diagnosis, referring providers and services based on facility and patient’s availability.
• Explains the content of all required forms and obtains signatures as appropriate.
• Reviews, assesses and evaluates patient registrations to ensure accuracy of demographic and financial information.
• Collects co-payment, deductible, and co-insurance amounts according to patient’s health insurance plan and contractual agreement.
• Refers self-pay patient to financial aid/self-pay representative.
• Operates telephone switchboards and consoles to connect, hold, transfer and disconnect telephone calls.
• Determines the nature of inquiries and provides general information.
• Connects calls to the required extension, re-direct them to another number or place them in a waiting queue if the desired number is busy.
• Provides external connections for staff and answer internal queries directed to the switchboard.
• Develops and maintains positive customer service with all patients, colleagues, visitors, and vendors by exercising utmost diplomacy and tact.
• Maintains current knowledge base regarding insurance information and managed care guidelines; maintains knowledge base of designated networks based upon managed care contracts.
• Demonstrates ability to utilize data retrieval insurance eligibility systems.
• Manages RQA reports by resolving errors and producing corrected accounts.
• Collaborates with other departments to ensure the needs of the patient and department are met.
• Abides by documentation guidelines consistently.
• Adheres to all company and department policies and procedures in confidentiality, regulatory or contractual mandates and HR policy.
• Practices confidentiality and privacy protocols in accordance to hospital policies and HIPAA requirements.
• Complies with departmental dress code and maintains a neat appearance.
• Performs other department specific duties as deemed appropriate by Patient Access leadership.

REQUIRED EXPERIENCE AND QUALIFICATIONS:

• Associate's degree.

  
  Or in lieu of degree, High School Diploma/GED and two (2) years’ combined experience in Revenue Cycle, Medical Office, or Business Office.

• Strong communication, interpersonal, and multitasking skills.
• Computer literacy and customer service skills.
  

PREFERRED EXPERIENCE AND QUALIFICATIONS:

• Knowledge of health insurance to help assisting patients in understanding medical insurance benefits.
• CPT, ICD-10, and medical terminology experience.