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Patient Access Facility Lead, Remote, FT, Days

Role overview

Summary

This role is for a Patient Access Facility Lead at Prisma Health, focusing on ensuring compliance with regulatory standards and optimizing patient registration processes. You will support the clinical team by collecting necessary patient information and educating team members on workflows, contributing to an efficient patient experience.

Qualifications

  • High School diploma or equivalent OR post-high school diploma/highest degree earned.
  • Four (4) years hospital admissions, billing and/or credit/collections experience.
  • Knowledge of third-party payment requirements, including Medicare and Medicaid.
  • Proficient computer skills including word processing, spreadsheets and database.
  • Preferred: Experience in a service-related position, including two (2) years in a lead capacity.

Responsibilities

  • Interview patients to obtain complete and accurate demographic and financial information in accordance with HIPAA guidelines.
  • Assist with the development of team member schedules and monitor daily performance to ensure compliance with departmental policies.
  • Act as a preceptor to educate team members on workflows and ensure compliance with required documents and forms.
  • Monitor daily collections and recommend improvements to maximize cash flow and minimize bad debt.

Key facts

Hard skills

Other skills

  • Team Leadership
  • Time Management
  • Communication
  • Problem Solving
  • Collaboration
  • Customer Service

About the company

Prisma Health logo

Prisma Health

  • Hospitals & Health Systems
  • XLarge
  • 10,001+
Prisma Health is the largest not-for-profit health organization in South Carolina, serving more than 1.2 million patients annually. The company has one Purpose: Inspire health. Serve with compassion. Be the difference. Prisma Health is comprised of two affiliates: Prisma Health–Upstate and Prisma Health– Midlands. Together they are dedicated to improving the health of all South Carolinians through improved clinical quality, access to care and patient experience, while also addressing the rising cost of health care. The affiliates are nationally recognized as some of the best places to work and to receive care. With more than 30,000 team members, physicians and volunteers, Prisma Health is the state’s largest private employer. Prisma Health works to improve the health of the local communities in the Midlands and Upstate regions through its community health programs. As one of the 50 largest health systems in the country, Prisma Health is committed to academic and clinical research excellence and focuses on educating the next generation of physicians, nurses, dentists and other medical professionals. The Prisma Health executive home office is in Greenville, South Carolina. For more information, visit www.prismahealth.org. ALERT: We will never request personal information and/or money in exchange for an interview and we do not conduct interviews via Google Meet or Google Chat. There have been reports of malicious people posing as Prisma Health hiring managers and conducting interviews with candidates via Google Meet or Google Chat. This is a phishing scam that could result in them taking your identity and/or money. Our hiring managers and recruiters do not conduct interviews via Google Meet or Google Chat. If you are contacted by someone claiming to be a Prisma Health team member, and they ask you to interview via a Google app, end communication immediately and report the action to the police.

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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

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.

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