Patient Access Specialist, FT, Nights

Prisma Health•Richland, SC

1d•Onsite

About The Position

The Patient Access Specialist receives and interviews patients to collect and verify demographic, financial, employment, and insurance information. The role enters accurate information into computer systems, checks that current insurance documentation is on file, follows up on missing information, verifies coverage and benefits, assigns insurance plans, and initiates pre-certification when required. The specialist obtains required signatures and forms, communicates estimated financial responsibility, requests payment, and directs patients to payment or financial assistance programs as appropriate. The position also receives payments and issues receipts, works toward collection goals, maintains cash funds and verification logs, and makes daily deposits in accordance with departmental policies. It prepares and distributes reports, documents, and patient identification items, and performs assigned duties courteously and professionally. This is a non-management role reporting to a supervisor, manager, director, or executive.

Requirements

High school diploma or equivalent, or a 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, following HIPAA guidelines, to obtain financial, demographic, and employment information.
Enter accurate information into the computer database, access Sovera to confirm 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 telephone inquiries, and document the results in the system.
Assign the appropriate insurance plan from the third-party database and ensure insurance priorities comply with third-party requirements and coordination of benefits.
Initiate pre-certification when required and obtain a signed waiver 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, schedules, productivity logs, collection reports, armbands, and patient valuables.
Communicate patients’ estimated financial responsibility and request payment before or at the time of service.
Refer patients who need extended payment terms to the Medical Services Payment Program and patients needing financial assistance to the appropriate program.
Perform other duties as assigned.