Patient Access Specialist, Clinic, PRN, Days

Prisma Health•Sumter, SC

23h•Onsite

About The Position

The Patient Access Specialist receives and interviews patients to collect and verify demographic and financial information, verifies insurance, and initiates pre-authorization when required. The role collects payments or arranges payment, performs assigned duties courteously and professionally, and may perform business office functions. This is a non-management position reporting to a supervisor, manager, director, or executive. The specialist interviews patients or other permitted sources in accordance with HIPAA guidelines; enters and verifies information in computer systems; follows up on missing information; and documents insurance verification. The role also obtains required authorizations, signatures, forms, and documents; processes payments and deposits; prepares and distributes reports and patient materials; communicates estimated financial responsibility; and directs patients to payment or financial-assistance programs as 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 preferred.
Familiarity with medical terminology preferred.

Responsibilities

Interview patients or other permitted sources to obtain financial, demographic, and employment information.
Enter accurate information into the computer database, check Sovera for the most recent insurance card, and scan documents according to departmental guidelines.
Follow up on incomplete or missing information.
Verify insurance coverage and benefits online or by telephone, and 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 pre-certification when required and obtain a signed waiver when pre-certification is required but has not 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, logs, reports, and armbands.
Communicate estimated financial responsibility and request payment before or at the time of service.
Refer patients who need extended payment terms to the Medical Services Payment Program and patients needing financial assistance to an appropriate program.
Perform other duties as assigned.
Perform assigned duties in a courteous and professional manner.