Patient Access
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Job Description
About company
Prisma Health is a healthcare organization committed to transforming healthcare for the benefit of the communities it serves. Their core values are to Inspire health. Serve with compassion. Be the difference. They believe that this transformation requires talented individuals in every role. The specific location for this role is Blount Memorial Hospital.
Job description, detailed
This role is for a Patient Access position within the Patient Access – BMH Department at Blount Memorial Hospital.
Job Summary
The primary purpose of this job is to receive and interview patients to gather and confirm their demographic and financial information. Key responsibilities include verifying insurance, initiating the pre-authorization process when required, and collecting payments or setting up necessary financial arrangements. The individual must perform all duties in a courteous and professional manner and may also carry out various business office functions.
Essential Functions (Key Responsibilities)
• Adherence to Values: Expected to be knowledgeable and compliant with Prisma Health’s values: Inspire health. Serve with compassion. Be the difference.
• Patient Interviewing & Data Management: Interviews patients or other sources (following HIPAA guidelines) to collect financial status, demographic, and employment information. Accurately enters data into the computer database, uses Sovera to ensure the latest insurance card is on file, and scans documents as per departmental guidelines. Follows up on incomplete or missing information.
• Insurance Verification & Pre-certification: Verifies insurance coverage and benefits using online eligibility tools or by contacting employers/third-party payers directly. All verified insurance information must be documented in the system. Assigns the correct insurance plan from the third-party database and ensures insurance priorities (e.g., Coordination of Benefits – COB) are accurate. Initiates the pre-certification process when required and obtains signed waivers if pre-certification is needed but not yet secured.
• Form Management: Obtains necessary signatures and information on required forms and documents, including but not limited to Consent Forms, Liability Assignments, and Waiver Letters.
• Payment Collection & Cash Handling: Receives payments, issues receipts, and actively contributes to collection goals. Manages cash funds and verification logs, and performs daily deposits according to established policies.
• Document Preparation & Distribution: Prepares and distributes various reports, documents, and patient identification items. This includes Privacy Notices, Patient Rights and Responsibilities, Patient Rights in Healthcare Decisions Brochures, Medicare Booklets, schedules, productivity logs, monthly collection reports, patient armbands, and manages patient valuables.
• Financial Communication: Communicates the estimated financial responsibility to patients and requests payment prior to or at the time of service. Refers patients needing extended payment terms to the Medical Services Payment Program and those needing financial assistance to appropriate programs.
• Other Duties: Performs additional tasks as assigned.
Supervisory/Management Responsibilities
This is a non-management position. The individual will report to a supervisor, manager, director, or executive.
Minimum Requirements
• Education: A High School diploma or equivalent OR a post-high school diploma/highest degree earned.
• Experience: A minimum of two (2) years of experience in Admissions, Billing, Collections, Insurance, and/or Customer Service.
Required Certifications, Registrations, Licenses
• None specified (NA).
Knowledge, Skills And Abilities (KSAs)
• Basic Computer Skills: Proficiency in word processing, spreadsheets, database management, and data entry.
• Office Equipment Knowledge: Familiarity with office equipment such as fax machines and copiers.
• Mathematical Skills: Competency in basic mathematical calculations.
• Preferred Skills:
• Experience with registration and scheduling.
• Familiarity with medical terminology.
Work Shift
• Weekend Shift (United States of America).
