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Urgent Admission Specialist F/T

Company: Prisma Health Upstate
Location: Greenville
Posted on: January 9, 2022

Job Description:

Inspire health. Serve with compassion. Be the difference.Job SummaryResponsible for communicating and providing information which meets the payor requirements for initial notification of Inpatient admissions and Observation, timely completion of insurance verification, and authorization related activities to financially secure patient accounts. This includes timely submission of appropriate documentation in order to meet third party payor requirements which helps ensure that Prisma Health receives timely and accurate reimbursement. Collaborates as appropriate with other departments to ensure efficient processes and facilitate problem solving.AccountabilitiesActs as the initial point of contact to all payors for Inpatient admissions and Observation. Includes timely submission of appropriate documentation as required by the payor(s) for the initial authorization/notification purposes. Ensures appropriate statistical data is obtained for patients in assigned patient population areas; communicating with payors timely and accurately.Updates and maintains authorization numbers and approved days in registration and/or other applicable systems as appropriate. Secures discharge dates for payers as assigned.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. Ensures insurance priorities are correct based on third party requirements/COB.Initiates pre-certification process as required according to departmental guidelines. Interviews patients or representatives (in accordance with HIPAA and EMTALA Guidelines) to secure information relative to financial status, demographic data and employment information when necessary. Enters accurate information into computer database. Accesses Sovera to review ensure the most recent insurance card is on file. Follows up for incomplete and missing information. Supervisory/Management ResponsibilitiesThis is a non-management job that report to a supervisor, manager, director or executive.Minimum RequirementsEducation - High School diploma or equivalentExperience - 3 years Revenue Cycle, Patient Access /Billing, Collections and/or Customer ServiceRequired Certifications/Registrations/Licensesn/aIn Lieu Of The Minimum Requirements Listed Aboven/aOther Required Skills and ExperienceMedical TerminologyBasic computer skillsKnowledge of office equipmentProficient computer skills (word processing)Data entryWork ShiftDay (United States of America)LocationPatewood Outpt Ctr/Med OfficesFacility7001 CorporateDepartment70019073 Patient Access SupportShare 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.

Keywords: Prisma Health Upstate, Greenville , Urgent Admission Specialist F/T, Other , Greenville, South Carolina

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