Patient Access Specialist, FT, 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 and maintains accurate records, verifies insurance coverage and benefits, and initiates pre-certification when required. It also obtains required signatures, collects payments or arranges payment, communicates estimated financial responsibility, and may perform business office functions. All duties are performed courteously and professionally in accordance with departmental policies and HIPAA guidelines.

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 in accordance with HIPAA guidelines.
Enter accurate information into computer databases, use Sovera to ensure the latest insurance card is on file, scan documents, 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 comply with third-party requirements and coordination of benefits.
Initiate pre-certification as required and obtain a signed waiver when required pre-certification has not yet been obtained.
Obtain signatures and information on required 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 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.