PATIENT SERVICE SPECIALIST-ED

Scripps Health•Encinitas, CA

15h

About The Position

Responsible for interacting with patients, payers and providers to gather information necessary for accurate registration including assigning of appropriate Medical Record Number, referral/authorization, point of service payment collection, document collection and arrival/check-in functions. Receives and routes messages received in the department appropriately as well as manages customer billing and payment inquires as needed. Effectively manages the patient check-in and check-out process from start to finish, which includes identification verification; updating or confirming demographic and insurance information on every patient; ensuring appropriate forms are provided, signed and witnessed at the time of the patient visit; verifying coverage including benefits, authorization, pre-determination, payer specific policy exclusions or limitations to coverage, collecting any patient responsibility and accurately preparing end of day reporting or payment reconciliation as needed. Assisting patients with HPE eligibility, discussing payment arrangement options including financial assistance information, providing price estimates. Regularly displays a proactive approach to customer service by listening to the patient, taking ownership of solutions and is able to accurately identify the need to involve leadership in order to resolve concerns. Acts as a member of the patient care team by supporting the clinical care staff in the care of the patient.

Requirements

Proficiency in computer applications.
Excellent mathematical skills.
Ability to handle monies.
Excellent communication skills.
Excellent customer service skills.
Strong organizational skills.
Strong analytical skills.
Ability to be innovative and solve problems.
Ability to adapt.
Ability to prioritize.
Ability to meet deadlines.

Nice To Haves

2 years of experience in customer service or a healthcare/medical office environment.
Knowledge of medical terminology.
Knowledge of commercial and government health insurance and billing guidelines.
Knowledge of ACA requirements.
Understanding of DRG's.
Knowledge of Medical ICD9/ICD10 codes.
Knowledge of CPT/HCPC Codes and Modifiers.

Responsibilities

Interact with patients, payers and providers to gather information for accurate registration.
Assign appropriate Medical Record Number.
Manage referral/authorization processes.
Collect point of service payments.
Collect necessary documents.
Perform arrival/check-in functions.
Receive and route departmental messages.
Manage customer billing and payment inquiries.
Manage the patient check-in and check-out process.
Verify patient identification.
Update or confirm demographic and insurance information.
Ensure appropriate forms are provided, signed, and witnessed.
Verify coverage, including benefits, authorization, and pre-determination.
Identify payer specific policy exclusions or limitations to coverage.
Collect patient responsibility payments.
Prepare end-of-day reporting or payment reconciliation.
Assist patients with HPE eligibility.
Discuss payment arrangement options and financial assistance.
Provide price estimates.
Demonstrate a proactive approach to customer service.
Listen to patients and take ownership of solutions.
Identify when leadership involvement is needed to resolve concerns.
Support clinical care staff as a member of the patient care team.