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Patient Access Coordinator

2 months ago


Seneca, 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 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 appropriate reports, documents, and patient identification items as required.
    • Communicate to patients 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.

Requirements

  • Education
    • High School diploma or equivalent OR post-high school diploma/highest degree earned.
  • Experience
    • 2 years of experience in admissions, billing, collections, insurance, and/or customer service.
  • Skills and Abilities
    • Basic computer skills.
    • Knowledge of office equipment (fax/copier).
    • Word processing.
    • Spreadsheets.
    • Database.
    • Data entry.
    • Mathematical skills.
    • Registration and scheduling experience (preferred).
    • Familiarity with medical terminology (preferred).