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Patient Access Representative

2 months ago


Greenville, South Carolina, United States Prisma Health Full time
Job Summary

We are seeking a highly 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 care they need in a timely and efficient manner.

Key Responsibilities
  • Verify patient demographic and financial information to ensure accurate billing and insurance coverage.
  • Interview patients to collect and verify financial data, including insurance information and employment details.
  • Enter accurate information into computer databases and access Sovera to ensure the most recent insurance card is on file.
  • Follow up with patients for incomplete or missing information and ensure that all necessary documents are signed and completed.
  • Verify insurance coverage and benefits using online eligibility or by telephone inquiry to the employer and/or third-party payor.
  • Assign appropriate insurance plans from the third-party database and ensure that insurance priorities are correct based on third-party requirements and COB.
  • Initiate pre-certification processes as required and obtain 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 towards collection goals.
  • Prepare and distribute reports, documents, and patient identification items as required.
  • Communicate with patients regarding their estimated financial responsibility and request payment prior to or at the time of service.
Requirements
  • High School Diploma or equivalent or post-high school education.
  • 2 years of experience in admissions, billing, collections, insurance, and/or customer service.
  • Basic computer skills and knowledge of office equipment, including fax and copier.
  • Word processing, spreadsheet, and database skills.
  • Mathematical skills and data entry experience.
  • Registration and scheduling experience preferred.
  • Familiarity with medical terminology preferred.
Work Environment

This is a non-management job that will report to a supervisor, manager, director, or executive.

Work will be performed in a fast-paced medical office environment with frequent interruptions and deadlines.