Patient Service Specialist - Case Management - La Jolla

Scripps Health•San Diego, CA

12h•Onsite

About The Position

The Patient Service Specialist supports the Case Management department at Scripps Memorial Hospital La Jolla. The role supports care managers and social workers with transitions of care, referral management through ECIN/CarePort, authorization management, and insurance and provider coordination. It also includes patient registration and check-in/check-out, customer inquiries, payment and billing support, and assistance with patient care team operations. This is a full-time position, 80 hours per pay period, with a varied day-shift schedule that includes every other weekend. The position is located at Scripps Memorial Hospital La Jolla. Scripps Health offers comprehensive benefits covering health and wellness, career development, and retirement options, along with transitional and professional development programs.

Requirements

Proficiency with computer applications.
Excellent mathematical skills and ability to handle money.
Excellent communication and customer service skills.
Strong organizational and analytical skills, with the ability to identify and solve problems.
Ability to adapt, prioritize, and meet deadlines.

Nice To Haves

Two years of experience in customer service or a healthcare/medical office environment.
Knowledge of medical terminology; commercial and government health insurance and billing guidelines; ACA requirements; DRGs; Medical ICD-9/ICD-10 codes; and CPT/HCPC codes.

Responsibilities

Support care managers and social workers with transitions of care, referral management through ECIN/CarePort, authorization management, and insurance and provider coordination.
Interact with patients, payers, and providers to gather information for accurate registration, including assigning the appropriate Medical Record Number, managing referrals and authorizations, collecting point-of-service payments, collecting documents, and handling arrival and check-in functions.
Receive and route department messages appropriately and manage customer billing and payment inquiries as needed.
Manage the patient check-in and check-out process, including verifying identity; updating or confirming demographic and insurance information; providing, collecting, and witnessing required forms; verifying coverage, benefits, authorizations, pre-determinations, and payer-specific exclusions or limitations; collecting patient responsibility; and preparing end-of-day reporting or payment reconciliation as needed.
Assist patients with HPE eligibility, discuss payment arrangement options and financial assistance information, and provide price estimates.
Provide proactive customer service by listening to patients, taking ownership of solutions, and identifying when leadership should be involved to resolve concerns.
Support clinical care staff as a member of the patient care team.