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Patient Access Coordinator
2 months ago
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 high-quality care by collecting and verifying demographic and financial data, verifying insurance coverage, and initiating pre-authorization processes when required.
Key Responsibilities
- Patient Data Collection
- Interview patients to collect and verify demographic and financial data, including insurance information and employment details.
- Enter accurate information into our computer database and ensure that the most recent insurance card is on file.
- Follow up with patients for incomplete or missing information.
- Insurance Verification
- Verify insurance coverage and benefits using online eligibility or by telephone inquiry to the employer and/or third-party payor.
- Document all information obtained through insurance verification in our system.
- 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.
- Payment and Collections
- 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.
- Maintain cash funds and verification logs, and make daily deposits according to departmental policies and procedures.
- Reporting and Communication
- Prepare and distribute reports, documents, and patient identification items as required, including privacy notices, patient rights and responsibilities, and patient valuables.
- Communicate with patients regarding their estimated financial responsibility and request payment prior to or at the time of service.
- Refer patients who may need extended terms to the Medical Services Payment Program and patients needing financial assistance to appropriate programs.
- Supervisory/Management Responsibilities
- This is a non-management role that will report to a supervisor, manager, director, or executive.
Requirements
- High School diploma or equivalent OR post-high school diploma/highest degree earned.
- 2 years of experience in admissions, billing, collections, insurance, and/or customer service.
Knowledge, Skills, and Abilities
- Basic computer skills.
- Knowledge of office equipment, including fax and copier.
- Word processing, spreadsheets, database, and data entry skills.
- Mathematical skills.
- Registration and scheduling experience preferred.
- Familiarity with medical terminology preferred.
