Patient Access Specialist, Clinic, PRN, Days

Prisma Health•Sumter, SC

About The Position

The Patient Access Specialist receives and interviews patients to collect and verify demographic, financial, employment, and insurance information. The role enters accurate information into computer systems, maintains required documentation, verifies insurance coverage and benefits, and initiates pre-certification when required. The specialist obtains required signatures, collects payments or arranges payment, communicates estimated financial responsibility, and refers patients to payment or financial-assistance programs when appropriate. The position also prepares and distributes patient documents and identification items, maintains cash funds and verification logs, makes daily deposits, and may perform business office functions. All duties are performed courteously and professionally, in compliance with HIPAA guidelines and departmental policies and procedures.

Requirements

High school diploma or equivalent, or post-high-school diploma/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 preferred.
Familiarity with medical terminology preferred.

Responsibilities

Interview patients or other authorized sources to obtain financial, demographic, and employment information, following HIPAA guidelines.
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 online or by telephone, document verification in the system, assign the appropriate insurance plan, and ensure insurance priorities meet third-party requirements and coordination-of-benefits rules.
Initiate pre-certification when required and obtain signed waivers when pre-certification has not yet been obtained.
Obtain required signatures and information on 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 refer patients needing financial assistance to the appropriate program.
Perform other duties as assigned.
Comply with Prisma Health’s purpose and applicable departmental guidelines and procedures.