Patient Access Representative

19 hours ago


Columbia, South Carolina, United States Prisma Health Full time

Job Summary

We are seeking a skilled Patient Access Specialist to join our team at Prisma Health. As a Patient Access Specialist, you will play a critical role in ensuring that patients receive the best possible care by collecting and verifying demographic and financial data, verifying insurance coverage, and initiating pre-authorization processes when required.

Key Responsibilities

  • Interview patients to collect and verify demographic and financial data, ensuring accuracy and completeness.
  • Verify insurance coverage and benefits, utilizing online eligibility or telephone inquiries to the employer and/or third-party payor.
  • Assign appropriate insurance plans from the third-party database, ensuring insurance priorities are correct based on third-party requirements/COB.
  • Initiate pre-certification processes as required, obtaining signed waivers for cases where pre-certification is required but not yet obtained.
  • Obtain necessary signatures and other information on appropriate forms and documents, including consent forms, liability assignments, and waiver letters.
  • Receive payments and issue receipts, actively working toward collection goals.
  • Prepare and distribute reports, documents, and patient identification items as required, including privacy notices, patient rights and responsibilities, and patient valuables.

Requirements

  • High School Diploma or equivalent.
  • 2 years of experience in admissions, billing, collections, insurance, and/or customer service.
  • Basic computer skills, including knowledge of office equipment and software.
  • Mathematical skills and ability to work accurately with numbers.

Preferred Qualifications

  • Registration and scheduling experience.
  • Familiarity with medical terminology.

Work Environment

This is a non-management job that will report to a supervisor, manager, director, or executive. The work environment is fast-paced and requires strong communication and organizational skills.



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