Pre-Service Patient Access Specialist

The-Spine-Hospital-of-Louisian; St. George (LA); On-site; USD 36,000 - 52,000; Full time

Job summary

The Patient Access Representative - Pre-Service at The-Spine-Hospital-of-Louisian is responsible for completing pre-service financial clearance and registration activities to ensure accurate billing and reimbursement. This role verifies insurance benefits, authorizations, diagnoses, and procedure codes, provides financial counseling, collects payments, and sets up payment arrangements before service.

The position focuses on reducing denials and improving upfront collections while upholding HIPAA

Qualifications

• High school diploma or equivalent required.
• Minimum of two (2) years of experience in healthcare scheduling or pre-registration preferred.
• Experience with registration, insurance verification, financial counseling, and customer service is strongly preferred.

Responsibilities

• Receive and review proposed services via phone, fax, email, or electronic worklists.
• Obtain and verify required pre-service documentation, including diagnoses, procedure codes, insurance eligibility, authorizations, and pre-certifications.
• Verify insurance benefits using Passport, payer portals, or other available resources to determine coverage and patient responsibility.
• Complete pre-registration by accurately entering demographic, insurance, financial, and medical information and creating patient accounts in the system.
• Counsel patients regarding insurance coverage, estimates, deductibles, co-insurance, and out-of-pocket responsibility.
• Collect pre-service payments and past-due balances and establish payment plans when appropriate.
• Communicate with clinic staff and physician offices to obtain authorization and pre-certification information and resolve discrepancies.
• Document all verification, authorization, and patient communications clearly and accurately in the patient account.
• Notify the Revenue Cycle Coordinator or Director of unusual cases, coverage issues, or extenuating circumstances requiring escalation.
• Maintain a high degree of accuracy and timeliness in all pre-service activities.
• Interact professionally and courteously with patients, families, providers, and internal departments.
• Provide backup support for other Patient Access or Revenue Cycle functions as needed.
• Maintain patient confidentiality and comply with all federal and state privacy regulations, including HIPAA.
• Support SHOLA’s culture of exceptional patient satisfaction and accountability.
• Performs special projects and other duties as assigned.

Skills

Customer service

Communication

Attention to detail

HIPAA compliance

Education

High school diploma or equivalent

Tools

Passport system

Payer portals

Job description

The Patient Access Representative - Pre-Service at The-Spine-Hospital-of-Louisian is responsible for completing pre-service financial clearance and registration activities to ensure accurate billing and reimbursement. This role verifies insurance benefits, authorizations, diagnoses, and procedure codes, provides financial counseling, collects payments, and sets up payment arrangements before service.

The position focuses on reducing denials and improving upfront collections while upholding HIPAA