Patient Access Specialist, PT, 3rd Shift

Prisma Health•Seneca, SC

26d•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 performs assigned duties in a courteous and professional manner. The position may also perform business office functions. For ED/IP registration, the role is scheduled for the 3rd shift, including weekends and one day a week. The specialist interviews patients or other sources in accordance with HIPAA guidelines; enters and verifies information in computer systems; follows up on missing information; and documents insurance verification. The specialist also obtains required signatures, forms, and pre-certification, communicates estimated financial responsibility, requests payment, 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.
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, 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 meet third-party requirements and coordination-of-benefits rules.
Initiate pre-certification as required 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, such as privacy notices, patient-rights materials, schedules, productivity logs, collection reports, armbands, and patient valuables.
Communicate estimated financial responsibility to patients 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.