Patient Access Specialist, Medicine Clinic-Main, FT, Days

Prisma Health•Greenville, SC

3d•Onsite

About The Position

The Patient Access Specialist receives and interviews patients to collect and verify demographic and financial information. The role verifies insurance coverage, initiates pre-authorization when required, collects payments or arranges payment, and completes assigned duties in a courteous and professional manner. The position may also perform business office functions. The specialist gathers and enters patient information in the computer database, checks that the current insurance card is on file, scans documents, and follows up on missing information. They verify benefits, document the results, select the appropriate insurance plan and priority, and initiate required pre-certification. They obtain signatures and required forms, communicate estimated financial responsibility, request payment, and refer patients to payment or financial-assistance programs when appropriate. The role also handles receipts, cash funds, verification logs, and daily deposits; prepares and distributes reports, documents, and patient identification items; and performs other duties as assigned. This is a non-management position reporting to a supervisor, manager, director, or executive.

Requirements

High school diploma or equivalent, or a post-high-school diploma or highest degree earned.
Two years of experience in admissions, billing, collections, insurance, and/or customer service.
Basic computer skills, including word processing, spreadsheets, databases, and data entry.
Mathematical skills.

Nice To Haves

Registration and scheduling experience.
Familiarity with medical terminology.

Responsibilities

Interview patients or other authorized sources, in accordance with HIPAA guidelines, to obtain financial, demographic, and employment information.
Enter accurate information into the computer database, check Sovera for the most recent insurance card, scan documents according to departmental guidelines, and follow up on incomplete or missing information.
Verify insurance coverage and benefits through online eligibility tools or telephone inquiries; document verification in the system.
Assign the appropriate insurance plan and ensure insurance priorities comply with third-party requirements and coordination-of-benefits rules.
Initiate required pre-certification and obtain signed waivers when pre-certification is required but has not yet been obtained.
Obtain signatures and information on required forms and documents, including consent forms, liability assignments, and waiver letters.
Receive payments, issue receipts, work toward collection goals, maintain cash funds and verification logs, and make daily deposits according to policy.
Prepare and distribute required reports, documents, and patient identification items, including notices, brochures, schedules, productivity logs, collection reports, armbands, and patient valuables.
Communicate patients’ estimated financial responsibility and request payment before or at the time of service.
Refer patients who may need extended payment terms to the Medical Services Payment Program and patients needing financial assistance to the appropriate program.
Perform other duties as assigned.