Role Description Responsible 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. Accountabilities - Acts as the initial point of contact to all payors for Inpatient admissions and Observation, including 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. - Documents information obtained through insurance verification 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 and ensure the most recent insurance card is on file. Follows up for incomplete and missing information. Supervisory/Management Responsibilities This is a non-management job that reports to a supervisor, manager, director or executive. Qualifications - Education - High School diploma or equivalent - Experience - 3 years in Revenue Cycle, Patient Access/Billing, Collections and/or Customer Service Requirements - Medical Terminology - Basic computer skills - Knowledge of office equipment - Proficient computer skills (word processing) - Data entry Work Shift Day (United States of America) Location 1200 Colonial Life Blvd Facility 7001 Corporate Department 70019073 PreAccess Services Company Description 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.

• Engages with patient, referral source, sales, pharmacy, and nursing to coordinate discharge and secure nursing and delivery. • Creates, communicates and obtains all required documentation for new referrals. • Secures patient’s upfront payment including assisting patients to find avenues for payment where needed (identifies opportunities and directs patient to financial assistance program). • Supports the ongoing activities needed to ensure clean claims on hold and denial management (follow-up on paperwork where missing). • Assist Supervisor and Manager with special assignments as needed.

• Deliver an outstanding, responsive customer experience by supporting patient, family, referral source, and insurance inquiries across phone, email, text, and chat. • Manage high-complexity insurance workflows, including secondary coverage, nuanced benefit structures, and multi-step authorization requirements. • Manage inbound support requests and conduct proactive outreach to collect required documentation, close gaps in care, resolve concerns, schedule client appointments and improve overall client outcomes. • Verify insurance benefits with accuracy, determine coverage/benefit limits, and ensure timely financial clearance prior to services. • Prepare, submit, and track prior authorizations using appropriate systems; communicate authorization status, issues, and requirements to clinicians, clients, and internal teams. • Support billing and financial inquiries by explaining charges, EOBs, deductibles, copays, payment plans, and financial policies; collect and process payments securely. • Partner closely with clinical, scheduling, and operations teams to ensure accurate treatment plan alignment, session readiness, and continuity of care. • Respond to internal inquiries about the status of in-process cases in a timely manner. • Partner with the Revenue Integrity and Payer Compliance teams to resolve front-end rejections and registration related denials which includes collecting and updating patient billing information to ensure accurate submission/resubmission of claims. • Maintain exemplary documentation quality in CRM/EHR systems, ensuring compliance with HIPAA, PCI, payer rules, and internal policies. • Identify recurring issues or inefficiencies and recommend updates to workflows, job aids, or scripts; support pilots and process-improvement initiatives. • Assist with onboarding and training of new team members by modeling strong communication, documentation, and case management practices. • Manage an independent caseload, consistently meeting SLAs, quality standards, and follow-through expectations across all assigned work.