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. The role verifies insurance coverage, initiates pre-authorization processes when required, collects payments or arranges payment plans, and performs assigned duties courteously and professionally. The specialist may also perform business office functions. The role interviews patients or other sources in accordance with HIPAA guidelines, enters and updates information in computer systems, follows up on incomplete information, documents insurance verification, and ensures insurance plans and priorities are correctly assigned. It obtains required signatures and forms, maintains payment and cash records, prepares and distributes reports and patient materials, communicates estimated financial responsibility, 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.
Knowledge of office equipment such as fax machines and copiers.
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, access Sovera to ensure the most recent insurance card is on file, and scan documents according to departmental guidelines.
Follow up on incomplete or missing information.
Verify insurance coverage and benefits through online eligibility tools or by contacting employers or third-party payors; document verification in the system.
Assign the appropriate insurance plan from the third-party database and ensure insurance priorities are correct based on third-party requirements and coordination of benefits.
Initiate pre-certification as required by departmental guidelines and obtain signed waivers 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, Medicare booklets, schedules, productivity logs, collection reports, patient 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.