Patient Access Facility Lead, Remote, FT, Days

Prisma; Columbia (SC); On-site; USD 42,000 - 54,000; Full time

Job summary

Prisma Health in Columbia, SC seeks a Patient Access Specialist to support registration, cash handling, and claims readiness. You will collect patient information, verify data for timely payments, and collaborate with Care Access leaders to optimize enrollment and compliance.

The role emphasizes HIPAA compliance, accuracy, and effective communication to ensure a smooth patient experience across the revenue cycle.

Qualifications

• Four years hospital admissions, billing and/or credit/collections experience.
• Ability to collect and verify patient demographics and financial information.
• Knowledge of health payor requirements and regulatory guidelines.

Responsibilities

• Interviews patients per HIPAA to obtain complete demographic and financial data for records and claims.
• Assist with daily cash handling and collecting patient balances in a compliant manner.
• Support clinical team by collecting information needed for health equity and CMS review.
• Precept staff on registration workflows to ensure efficient patient experiences.
• Communicate payor requirements to maximize cash flow and timely payments.

Skills

HIPAA compliance

Cash handling

Strong communication

Customer service

Education

High School diploma or equivalent

Associate degree (optional)

Tools

MS Word

Excel

Job description

Inspire health. Serve with compassion. Be the difference.

Job Summary

Performs functions of moderate to difficult complexity with high visibility and high risk from a compliance and regulatory standpoint. Assists Management with training, orienting and monitoring day to day performance of team members to ensure departmental policies and processes are being followed, responsible for daily cash handling procedures, assists with the development of team member schedules and registers patients. Subject Matter Expert for the department.

Essential Functions

• All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference.
• Interviews patient or other sources, in accordance with HIPAA guidelines, to obtain complete and accurate patient demographic and financial information for the purpose of establishing the patient record and facilitating timely claims payment.
• Collects and records information that supports the clinical team with ensuring requirements are met surrounding health equity and the social determinates of healthcare, which is subject to review by CMS and the joint Commission.
• Performs routine account analysis and problem solving. Alleviates difficult situations and handles patient inquiries and/or concerns.
• Acts as a preceptor to ensure team members are equipped to complete efficient registration processes to support an optimal patient experience. This includes collecting demographic and financial information, in accordance with HIPAA guidelines, to facilitate timely payment, discussing the patient estimate and collecting patient balances due. A further responsibility includes collecting and recording information in the system that supports the clinical team with health equity and the social determinates of healthcare. This information is subject to review by The Joint Commission and state health department. Includes education for team members that outlines specific workflows to be followed.
• Acts as a preceptor to ensures compliance with the provision of documents and forms as required by regulation; in some instances, signatures are required. Compliance regarding documents and forms is subject to review by CMS, state health department, and the Joint Commission. These forms/documents include but are not limited to Advance Directives, Lewis Blackman Patient Safety Act, Notice of Privacy Practices, Patient Rights and Responsibilities, Permission to Treat, Limited Visitation Policy, Medicare Admission Questionnaire, Medicare Important Message and Medicare Outpatient Observation Notice. Lack of compliance can create a regulatory finding or jeopardize participation with CMS.
• Maximizes collections and minimizes bad debt by providing estimated costs for patient responsibility at time of service. Collects current and past balances in accordance with departmental cash handling procedures. Monitors daily collections to identify trends and to recommend improvements.
• Collaborates with Patent Access Leadership to coordinate team member schedules, including scheduling rotation, time off, and call-offs as necessary. Ensures adequate coverage in accordance with organizational policies. Minimizes overtime while maximizing productivity. May be required to fill in for call-offs, staffing issues, or unexpected volumes.
• Provides education to inform team members of relevant changes and developments in payor requirements. Pivots to meet the changing needs of payor requirements to maximize cash flow for the organization.
• Performs other duties as assigned.

Supervisory/Management Responsibilities

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

Minimum Requirements

• Education - High School diploma or equivalent OR post-high school diploma/highest degree earned
• Experience - Four (4) years hospital admissions, billing and/or credit/collections experience

In Lieu Of

• In lieu of education and experience detailed above, four (4) years in a service-related position (i.e., customer service in a business/office setting, banking, or finance) to include two (2) years in a lead capacity. Preference is given to candidates with experience in hospital admissions, billing, or credit/collections.
• In lieu of education and experience detailed above, an Associate degree and two (2) years of experience may be considered.
• In lieu of education and experience detailed above, Bachelor's degree plus one (1) year experience may be considered

Required Certifications, Registrations, Licenses

• NA

Knowledge, Skills And Abilities

• Maintains a working knowledge of third-party payment requirements, including (as applicable) Medicare, Medicaid, managed care organizations, private insurers, and worker's compensation carriers.
• Ability to foster an environment that focuses on an optimal patient experience through accountability, collaboration, team member participation, and effective communication
• Proficient computer skills including word processing, spreadsheets and database

Work Shift

Day (United States of America)

Location

Corporate - Columbia - Taylor at Marion

Facility

Corporate

Department

PreAccess Services