Patient Access Specialist, Medicine Clinic-Main, 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 when required, collects payments or arranges payment, and performs assigned duties courteously and professionally. The specialist may also perform business office functions. The position interviews patients or other sources in accordance with HIPAA guidelines; enters and updates information in computer systems; verifies insurance benefits; documents verification; obtains required signatures and forms; and follows departmental guidelines for pre-certification. It also receives payments, issues receipts, maintains cash funds and verification logs, makes daily deposits, and prepares and distributes required reports and patient materials. The specialist communicates estimated financial responsibility, requests payment before or at service, and refers patients to appropriate payment or financial-assistance programs.

Requirements

High school diploma or equivalent, or a post-high-school diploma or 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 collect financial, demographic, and employment information.
Enter accurate information into computer databases, check that the most recent insurance card is on file in Sovera, scan documents, and follow up on missing or incomplete information.
Verify insurance coverage and benefits through 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.
Initiate pre-certification when 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, and work toward collection goals.
Maintain cash funds and verification logs, and make daily deposits in accordance with departmental policies and procedures.
Prepare and distribute reports, documents, schedules, productivity logs, collection reports, patient identification items, and other required patient materials.
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 refer patients needing financial assistance to the appropriate program.
Perform other duties as assigned.