Patient Access Specialist, Woodward Center Greenville, 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 involves entering and maintaining accurate patient information, checking insurance documentation, following up on missing information, obtaining required signatures, and explaining estimated financial responsibility to patients. It also includes receiving payments, maintaining cash funds and verification logs, making daily deposits, preparing required reports and patient materials, and referring patients to payment or financial-assistance programs when 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.
Knowledge of office equipment such as fax machines and copiers.
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 status, 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 to employers or third-party payors, and document the information 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 rules.
Initiate pre-certification as required by departmental guidelines and obtain signed waivers when required pre-certification has not been obtained.
Obtain necessary 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 in accordance with departmental policies and procedures.
Prepare and distribute required reports, documents, and patient identification items, including privacy notices, patient rights materials, Medicare booklets, schedules, productivity logs, monthly collection reports, patient armbands, and patient valuables.
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.
Perform assigned duties in a courteous and professional manner.