Patient Access Specialist, FT, Days

Prisma Health•Sumter, SC

2d•Onsite

About The Position

The Patient Access Specialist receives and interviews patients to collect and verify demographic, employment, and financial information. The role verifies insurance coverage and benefits, assigns insurance plans and priorities, and initiates pre-certification when required. It also collects payments or arranges payment plans, communicates estimated financial responsibility, and refers patients to payment or financial assistance programs when appropriate. The specialist enters and verifies information in computer systems, accesses Sovera to confirm the latest insurance card is on file, scans documents, follows up on missing information, obtains required signatures, and prepares and distributes reports and patient documents. The role maintains cash funds and verification logs, makes daily deposits, and performs assigned duties courteously and professionally. It may include business office functions.

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 sources in accordance with 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 to employers or third-party payors, and document verification in the system.
Assign the appropriate insurance plan and ensure insurance priorities comply with third-party requirements and coordination-of-benefits rules.
Initiate pre-certification as 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, and work toward collection goals.
Maintain cash funds and verification logs and make daily deposits according to departmental policies and procedures.
Prepare and distribute required reports, documents, and patient identification items, including privacy notices, patient rights materials, schedules, productivity logs, collection reports, patient armbands, and patient valuables.
Communicate estimated financial responsibility to patients 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 duties in a courteous and professional manner.