Patient Access Specialist, FT, Days

Prisma Health•Greenville, SC

About The Position

The Patient Access Specialist receives and interviews patients to collect and verify demographic and financial information, verifies insurance, initiates pre-authorization when required, and collects payments or arranges payment. The specialist performs assigned duties courteously and professionally and may also perform business office functions. This role interviews patients or other information sources in accordance with HIPAA guidelines; enters and updates information in computer systems; verifies insurance coverage and benefits; documents verification; assigns insurance plans and confirms coverage priorities; and initiates pre-certification as required. The specialist obtains required signatures and forms, collects payments and issues receipts, maintains cash funds and verification logs, and makes daily deposits according to departmental procedures. The role also prepares and distributes reports, documents, and patient identification items; explains estimated financial responsibility and requests payment before or at service; and refers patients to payment or financial-assistance programs when appropriate.

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.
Familiarity with medical terminology.

Responsibilities

Interview patients or other 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, and follow up on missing or incomplete information.
Verify insurance coverage and benefits using online eligibility tools or telephone inquiries, and document the results in the system.
Assign the appropriate insurance plan and ensure insurance priorities comply with third-party requirements and coordination-of-benefits rules.
Initiate pre-certification as required and obtain a signed waiver when required 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 privacy notices, patient-rights materials, schedules, productivity logs, collection reports, armbands, and patient valuables.
Communicate 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.