Patient Access Specialist, FT, Nights

Prisma Health; Greenville (SC); On-site; USD 32,000 - 43,000; Full time

Job summary

Prisma Health in Greenville Memorial Hospital is seeking a Patient Access Associate to interview patients, verify demographics and financial data, and initiate pre-authorization when needed. The role involves confirming insurance details, collecting payments, and handling reports while maintaining HIPAA compliance.

Night shift opportunities exist, with responsibilities including communicating financial responsibilities to patients and guiding them to payment arrangements.

Qualifications

• High School diploma or equivalent is required.
• Two years of Admissions, Billing, Collections, Insurance and/or Customer Service experience.
• Familiarity with HIPAA guidelines and medical terminology preferred.
• Basic computer skills and ability to navigate databases and forms.

Responsibilities

• Interview patients to collect demographic and financial data and verify information.
• Verify insurance coverage and initiate pre-certification when required.
• Collect payments and manage daily deposits per policies and procedures.
• Prepare reports and patient identification materials as needed.
• Communicate estimated financial responsibility to patients and arrange payment plans as appropriate.
• Perform other duties as assigned.

Skills

Basic computer skills

Mathematical skills

Registration & scheduling experience

Familiarity with medical terminology

Education

High School diploma or equivalent

Tools

Sovera

Database access

Job description

Inspire health. Serve with compassion. Be the difference.

Job Summary

Receives and interviews patients to collect and verify pertinent demographic and financial data. Verifies insurance and initiates pre-authorization process when required. Collects required payments or makes necessary financial arrangements. Performs all assigned duties in a courteous and professional manner. May perform business office functions.

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 source (in accordance with HIPAA Guidelines) to secure information relative to financial status, demographic data and employment information. Enters accurate information into computer database, accesses Sovera to ensure the most recent insurance card is on file, and scans documents according to departmental guidelines. Follows up for incomplete and missing information.
• Verifies insurance coverage/benefits utilizing online eligibility or by telephone inquiry to the employer and/or third-party payor. Information obtained through insurance verification must always be documented in the system. Assigns appropriate insurance plan from the third-party database; ensures insurance priorities are correct based on third-party requirements/ COB. Initiates pre-certification process as required according to Departmental Guidelines; obtains signed waiver for cases where pre-certification is required but not yet obtained.
• Obtains necessary signatures and other information on appropriate forms and documents as required including, but not limited to, Consent Form, Liability Assignment, and Waiver Letter.
• Receives payments and issues receipts, actively working toward collection goals. Maintains cash funds/verification logs and makes daily deposits according to departmental policies and procedures.
• Prepares and distributes appropriate reports, documents, and patient identification items as required. This includes, but is not limited to, Privacy Notice, Patient Rights and Responsibilities, Patient Rights in Healthcare Decisions Brochure, Medicare Booklet, schedules, productivity logs, monthly collection reports, patient armbands, patient valuables, etc.
• Communicates to patients their estimated financial responsibility. Requests payment prior to or at the time of service. Refers patients who may need extended terms to the Medical Services Payment Program and patients needing financial assistance to appropriate program.
• 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 - Two (2) years of Admissions, Billing, Collections, Insurance and/or Customer Service

In Lieu Of

• NA

Required Certifications, Registrations, Licenses

• NA

Knowledge, Skills And Abilities

• Basic computer skills (word processing, spreadsheets, database, data entry)
• Mathematical skills
• Registration and scheduling experience preferred
• Familiarity with medical terminology preferred

Work Shift

Night (United States of America)

Location

Greenville Memorial Hospital

Facility

Corporate

Department

Patient Access-GMH Campus

Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.