Patient Access Specialist, PRN, Night

Prisma Health•Greer, SC

1d•Onsite

About The Position

The Patient Access Specialist receives and interviews patients to collect and verify pertinent demographic and financial data. This role involves verifying insurance, initiating the pre-authorization process when required, and collecting necessary payments or arranging financial plans. The specialist is expected to perform all duties courteously and professionally and may also handle business office functions. Essential functions include interviewing patients or other sources to secure financial, demographic, and employment information, accurately entering data into the computer system, scanning documents, and following up on incomplete information. The specialist verifies insurance coverage and benefits, assigns appropriate insurance plans, ensures correct insurance priorities, and initiates pre-certification processes. They obtain necessary signatures on forms, receive payments, issue receipts, maintain cash funds, and make daily deposits. Additionally, the role involves preparing and distributing reports, documents, and patient identification items, communicating estimated financial responsibility to patients, requesting payment at the time of service, and referring patients to financial assistance programs as needed.

Requirements

High School diploma or equivalent OR post-high school diploma/highest degree earned
Two (2) years of Admissions, Billing, Collections, Insurance and/or Customer Service experience
Basic computer skills (word processing, spreadsheets, database, data entry)

Nice To Haves

Registration and scheduling experience preferred
Familiarity with medical terminology preferred

Responsibilities

Receives and interviews patients to collect and verify pertinent demographic and financial data.
Verifies insurance and initiates pre-authorization process when required.
Collects required payments or makes necessary financial arrangements.
Performs all assigned duties in a courteous and professional manner.
May perform business office functions.
Interviews patient or other source (in accordance with HIPAA Guidelines) to secure information relative to financial status, demographic data and employment information.
Enters accurate information into computer database, accesses Sovera to ensure the most recent insurance card is on file, and scans documents according to departmental guidelines.
Follows up for incomplete and missing information.
Verifies insurance coverage/benefits utilizing online eligibility or by telephone inquiry to the employer and/or third-party payor.
Documents information obtained through insurance verification in the system.
Assigns appropriate insurance plan from the third-party database; ensures insurance priorities are correct based on third-party requirements/ COB.
Initiates pre-certification process as required according to Departmental Guidelines; obtains signed waiver for cases where pre-certification is required but not yet obtained.
Obtains necessary signatures and other information on appropriate forms and documents as required including, but not limited to, Consent Form, Liability Assignment, and Waiver Letter.
Receives payments and issues receipts, actively working toward collection goals.
Maintains cash funds/verification logs and makes daily deposits according to departmental policies and procedures.
Prepares and distributes appropriate reports, documents, and patient identification items as required.
Communicates to patients their estimated financial responsibility.
Requests payment prior to or at the time of service.
Refers patients who may need extended terms to the Medical Services Payment Program and patients needing financial assistance to appropriate program.
Performs other duties as assigned.