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Medical Office Receptionist

2 months ago

Simpsonville, South Carolina, United States Prisma Health Full time

About This Role

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 accurately collecting and verifying demographic and financial information.

Key Responsibilities

  • Interviews and Data Collection
    • Conduct thorough interviews with patients to collect and verify demographic and financial data, ensuring accuracy and completeness.
    • Enter accurate information into computer databases and access Sovera to ensure the most recent insurance card is on file.
    • Scan documents according to departmental guidelines and follow up for incomplete and 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 information obtained through insurance verification in the system.
    • Assign appropriate insurance plans from the third-party database and ensure insurance priorities are correct based on third-party requirements/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.
    • Receive payments and issue receipts, actively working toward collection goals.
    • Maintain cash funds/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 and Experience
    • High School Diploma or equivalent or post-high school education.
    • 2 years of experience in Admissions, Billing, Collections, Insurance, and/or Customer Service.
  • Skills and Qualifications
    • 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).

Work Environment

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

Language

English (United States)