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Patient Access Representative
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
- Interviews and Data Collection
Interview patients or other sources to secure information relative to financial status, demographic data, and employment information. Enter accurate information into computer databases and access Sovera to ensure the most recent insurance card is on file.
Insurance VerificationVerify insurance coverage and benefits utilizing online eligibility or by telephone inquiry to the employer and/or third-party payor. Document all information obtained through insurance verification in the system.
Pre-Certification and AuthorizationInitiate pre-certification processes as required according to departmental guidelines. Obtain signed waivers for cases where pre-certification is required but not yet obtained.
Payment and CollectionsObtain necessary signatures and other information on appropriate forms and documents. Receive payments and issue receipts, actively working toward collection goals.
Reporting and DocumentationPrepare and distribute appropriate reports, documents, and patient identification items as required.
Requirements
- Education
High School Diploma or equivalent
Experience2 years of experience in Admissions, Billing, Collections, Insurance, and/or Customer Service
Certifications/Registrations/LicensesN/A
Preferred Skills and Experience
- Computer Skills
Basic computer skills, including knowledge of office equipment and software
Registration and Scheduling ExperienceRegistration and scheduling experience preferred
Familiarity with Medical TerminologyFamiliarity with medical terminology preferred
Work Environment
This is a non-management job that will report to a supervisor, manager, director, or executive.
