PATIENT ACCESS SERVICES REP I, PATIENT ACCESS SERVICES
SGMC Health, Valdosta, GA, United States
WHAT IT'S LIKE AT SGMC HEALTH
At SGMC Health we work together towards goals that will make our community a better place. We strive to do the right thing the right way, are accountable in everything we do, require competence from our people, and are compassionate in our service. We encourage team effort, support personal and professional development, acknowledge individual talents and skills, and support innovation and empowerment. We are committed to providing the best care possible and are proud to be recognized locally, statewide, and nationally for the exceptional care our staff provides.
Benefits
Low Health Care Insurance Premiums
401(k) with employer match
Paid Time Off (PTO)
Employee discounts
Company paid life insurance
Short-Term and Long-Term Disability
Cancer Insurance
Accident Insurance
Pet Insurance
Tuition Reimbursement
On-the-job training and skills development
Opportunities for growth and advancement
Employee Assistance Program
Job Location
SGMC Patient Financial Services
Department
Patient Access Services (PAS)
Schedule
Full Time, 8 HR Day Shift
Position Summary
Responsible for all aspects of scheduling inpatient and outpatient procedures, recording patients into the lobbying system, handling complete patient registration, patient transfers, and bed placements. Must meet a standard productivity rate of 94%–105% and a standard accuracy rate of 98% or higher in AHIQA. Must understand and comply with HIPAA, Medicare, and Medicaid requirements, verify insurance benefits, and input patient demographics and financial data accurately. Responsibilities also include fulfilling PayNav functions – medical necessity reviews, cost estimates, and insurance verification for all patients – and meeting a personalized collection goal of 100%. The role coordinates referral of accounts to appropriate personnel and maintains, responds to, and addresses SGMC Health emails, phone calls, and voice messages.
Knowledge, Skills & Abilities
PC and Windows literacy; familiarity with Series, Trace, PayNav, and Microsoft Office applications.
Extensive knowledge of insurance/managed care, including Medicare, Medicaid (Georgia and Florida), Peach Care, Tricare (Standard, Extra & Prime), VA, disability adjudication services, vocational rehabilitation, children’s medical services, cancer state aid, crime victim’s compensation program, knight’s templar eye foundation, HMO, PPO, POS, COBRA, worker’s compensation, and institutional billing.
Strong verbal communication and excellent customer service skills; interacts with patients, departments, physician offices, acute care providers, insurance companies, pre-certification companies, employers, intermediaries, utilization review companies, and state regulatory agencies.
Knowledge of medical terminology, CPT, HCPCS, and ICD-10; familiarity with PCI compliance and regulatory requirements such as Medicare Secondary Payer Questionnaire, advance directives, medical necessity checks, and coordination of benefits.
Understanding of patient type, financial class, insurance master, employer codes, clinic codes, physician coding, admission source codes, relationship codes, accommodation codes, and medical service codes.
College degree or coursework preferred; CPAR preferred.
Ability to organize workload efficiently and type 40 WPM accurately.
Previous experience with data entry, programming, or office coordination highly preferred.
Working Conditions & ADA Information
Modern, well‑lighted, air‑conditioned general work area with moderate noise. Occasional overtime may be required. The employee may be exposed to blood and body fluids. Work requires sitting, standing, walking, and moderate lifting (0–25 lbs.). Safe and efficient operation of office equipment including copier, fax, printers, computer, telephone, adding machine, Medifax, and credit card machine is necessary. Job also requires reading printed materials, listening, and verbally responding to customers, staff, physicians, and visitors, and moderate heavy lifting and bending.
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At SGMC Health we work together towards goals that will make our community a better place. We strive to do the right thing the right way, are accountable in everything we do, require competence from our people, and are compassionate in our service. We encourage team effort, support personal and professional development, acknowledge individual talents and skills, and support innovation and empowerment. We are committed to providing the best care possible and are proud to be recognized locally, statewide, and nationally for the exceptional care our staff provides.
Benefits
Low Health Care Insurance Premiums
401(k) with employer match
Paid Time Off (PTO)
Employee discounts
Company paid life insurance
Short-Term and Long-Term Disability
Cancer Insurance
Accident Insurance
Pet Insurance
Tuition Reimbursement
On-the-job training and skills development
Opportunities for growth and advancement
Employee Assistance Program
Job Location
SGMC Patient Financial Services
Department
Patient Access Services (PAS)
Schedule
Full Time, 8 HR Day Shift
Position Summary
Responsible for all aspects of scheduling inpatient and outpatient procedures, recording patients into the lobbying system, handling complete patient registration, patient transfers, and bed placements. Must meet a standard productivity rate of 94%–105% and a standard accuracy rate of 98% or higher in AHIQA. Must understand and comply with HIPAA, Medicare, and Medicaid requirements, verify insurance benefits, and input patient demographics and financial data accurately. Responsibilities also include fulfilling PayNav functions – medical necessity reviews, cost estimates, and insurance verification for all patients – and meeting a personalized collection goal of 100%. The role coordinates referral of accounts to appropriate personnel and maintains, responds to, and addresses SGMC Health emails, phone calls, and voice messages.
Knowledge, Skills & Abilities
PC and Windows literacy; familiarity with Series, Trace, PayNav, and Microsoft Office applications.
Extensive knowledge of insurance/managed care, including Medicare, Medicaid (Georgia and Florida), Peach Care, Tricare (Standard, Extra & Prime), VA, disability adjudication services, vocational rehabilitation, children’s medical services, cancer state aid, crime victim’s compensation program, knight’s templar eye foundation, HMO, PPO, POS, COBRA, worker’s compensation, and institutional billing.
Strong verbal communication and excellent customer service skills; interacts with patients, departments, physician offices, acute care providers, insurance companies, pre-certification companies, employers, intermediaries, utilization review companies, and state regulatory agencies.
Knowledge of medical terminology, CPT, HCPCS, and ICD-10; familiarity with PCI compliance and regulatory requirements such as Medicare Secondary Payer Questionnaire, advance directives, medical necessity checks, and coordination of benefits.
Understanding of patient type, financial class, insurance master, employer codes, clinic codes, physician coding, admission source codes, relationship codes, accommodation codes, and medical service codes.
College degree or coursework preferred; CPAR preferred.
Ability to organize workload efficiently and type 40 WPM accurately.
Previous experience with data entry, programming, or office coordination highly preferred.
Working Conditions & ADA Information
Modern, well‑lighted, air‑conditioned general work area with moderate noise. Occasional overtime may be required. The employee may be exposed to blood and body fluids. Work requires sitting, standing, walking, and moderate lifting (0–25 lbs.). Safe and efficient operation of office equipment including copier, fax, printers, computer, telephone, adding machine, Medifax, and credit card machine is necessary. Job also requires reading printed materials, listening, and verbally responding to customers, staff, physicians, and visitors, and moderate heavy lifting and bending.
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