Health Specialist Jobs

About The Position

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.
• Familiarity with medical terminology.

Responsibilities

• Interview patients or other authorized sources in accordance with HIPAA guidelines to obtain financial, demographic, and employment information; enter accurate information into the database, check Sovera for the most recent insurance card, scan documents, and follow up on missing information.
• Verify insurance coverage and benefits through online eligibility tools or telephone inquiries, document verification results, assign the appropriate insurance plan, and confirm insurance priorities in accordance with third-party requirements and coordination of benefits.
• Initiate pre-certification as required and obtain a signed waiver when required pre-certification has not 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 departmental policies and procedures.
• Prepare and distribute required reports, documents, schedules, productivity logs, monthly collection reports, and patient identification items and materials, including patient armbands and 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 direct patients seeking financial assistance to the appropriate program.
• Perform other duties as assigned.
• Comply with Prisma Health's purpose and expectations.