Columbia, South Carolina, United States · On-site
Inspire health. Serve with compassion. Be the difference. Job Summary Provides patients a seamless entry into the Prisma Health experience. Interfaces with patients and physician office team members to accurately authori…
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Columbia, South Carolina, United States · On-site
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Columbia, South Carolina, United States · On-site
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Columbia, South Carolina, United States · On-site
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Richland, Washington, United States · On-site
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Columbia, South Carolina, United States · On-site
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Richland, Washington, United States · On-site
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Richland, Washington, United States · On-site
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Richland, Washington, United States · On-site
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Richland, Washington, United States · On-site
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Columbia, South Carolina, United States · On-site
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Columbia, South Carolina, United States · On-site
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Columbia, South Carolina, United States · On-site
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Columbia, South Carolina, United States · On-site
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Skills: Patient Assessment, Care Planning, Evidence-Based Practice, Patient Advocacy, Clinical Competency
Columbia, South Carolina, United States · On-site
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Columbia, South Carolina, United States · On-site
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Richland, Washington, United States · On-site
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Columbia, South Carolina, United States · On-site
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Columbia, South Carolina, United States · On-site
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Columbia, South Carolina, United States • On-site
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Coordinates the authorization and precertification process for patient consultations, procedures, and tests. Acts as a liaison between patients, providers, and insurance companies to ensure seamless entry into healthcare services.
Requires a high school diploma or equivalent and two years of related work experience. Preferred experience includes physician front office work, patient registration, and knowledge of medical coding and insurance verification.
Job Summary
Provides patients a seamless entry into the Prisma Health experience. Interfaces with patients and physician office team members to accurately authorize various consultations, procedures and tests. Utilizes each patient’s preferred method of contact. Utilizes various electronic medical records to transmit required clinical documentation to third party payors and Specialist Physicians. Responsibilities include documenting all actions and encounters regarding the referral including timely follow up with the patient, referring and referral physician practice and third-party payors including pre-certification, cancelled and rescheduled appointments, and other events preventing closure of the referral experience.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.
Responsible for the authorization/precertification process to include coordinating with outside and internal organizations along with insurance companies to ensure prior approval requirements are met. Presents necessary medical information such as history, diagnosis and prognosis. Provides specific medical information to financial services to maximize reimbursement to the hospital and physicians.
Records demographic, coverage, and scheduling information in various systems. Reminds patients of scheduled appointments via mail, internet, or telephone. Ensures that patient’s primary care chart is up to date with scheduling information about specialist consults, tests, and procedures managed. Alerts management to trends in appointment availability and appointment date timeliness.
Promotes hospital goals towards meaningful use in the electronic medical record on behalf of the referring physician. Documents referral status and all scheduled appointments in appropriate system (electronic medical record) for referral tracking data. Responsible for following up after patient’s consultation, procedure, and/or test to determine if physician has received report; continues to check on status until complete.
Serves as liaison between the provider, practice, patient and specialist providing the service. Provides appropriate patient clinical information and referral needs to specialist office.
Verifies physician’s orders to ensure the accuracy of results and communicates with the patient the guidelines, protocols and location.
Assists patients in problem solving potential issues related to navigating the health care system, financial obligations or social barriers (e.g., request interpreters if appropriate, transportation services or prescription assistance). May assume advocate role on the patient’s behalf with the carrier to ensure approval of the necessary supplies/services for the patient in a timely fashion.
Responds to patient’s scheduling requirements (date and time), questions and concerns to ensure patient experience expectations are met or exceeded.
Ensures timely appointments are booked, reviews details and expectations about the referral process with patients.
Maintains patient confidentiality; complies with HIPAA and compliance guidelines established by Prisma Health.
Ensures the effective and efficient operation of the facility and to create an extraordinary patient, physician and team member experience.
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 Experience
Education - High School diploma or equivalent preferred
Experience - Two (2) years of related work experience. Experience in a physician front office to include patient registration and/or electronic scheduling and the authorization/precertification process preferred
In Lieu Of
In lieu of education/experience noted above, equivalent work and/or experience may be considered (i.e., Associate degree or higher level of education)
Required Certifications, Registrations, Licenses
Knowledge, Skills or Abilities
Customer service skills
Communication skills
Interpersonal skills
Knowledge of various health insurance companies.
Knowledge of medical terminology, CPT and Diagnosis Coding, insurance verification and updates, and the authorization/precertification process.
Knowledge of Microsoft office products.
Work Shift
Day (United States of America)Location
RichlandFacility
3108 Ophthalmology 4 Med ParkDepartment
31081000 Ophthalmology 4 Med Park-Practice OperationsShare 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.
Our Purpose: Inspire health. Serve with compassion. Be the difference.
Prisma Health is the largest not-for-profit health organization in South Carolina, serving more than 1.2 million patients annually. Our facilities in the Greenville and Columbia surrounding markets 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. Our Purpose: Inspire health. Serve with compassion. Be the difference.
Offices: 300 E McBee Ave, Greenville, South Carolina 29601, US
There are currently 297 open healthcare positions in Richland, WA listed on Clera. New openings are added daily as companies post roles.
Companies currently hiring include Prisma Health, PROVIDENCE MEDICAL INSTITUTE, Brookdale, Tri-Cities Chaplaincy, DaVita Kidney Care, among others. Browse the listings above to see every active employer.
Yes — 4 of the 297 open healthcare positions offer remote or hybrid work (1 remote, 3 hybrid).
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.
