At Scripps Health, you will experience the pride, support, and respect of an organization that has been repeatedly recognized as one of the nation’s Top 100 Places to Work.

You’ll be surrounded by people committed to making a difference in the lives of their patients and their teammates. So if you’re open to change, go ahead and unlock your potential.

Join the Case Management team at Scripps Memorial Hospital La Jolla as a Patient Service Representative. In this important role, your primary responsibilities will be sending referrals to post-acute providers and placement, coordinating transportation services, creating durable medical equipment referrals and delivering equipment to patients' rooms that is already in house, calling and waiting for insurance authorizations and notification to insurance of stability for patient transfer, sending CMS medical records for discharge appeals, and sending Medi-Cal admin day referrals.

General PSR duties may include:

• Interacting with patients, payers and providers to gather information necessary for accurate registration including assigning of appropriate medical record number, scheduling, and referral/authorization, point of service payment collection, document collection and arrival/check-in functions
• Responding to customer billing and payment inquires as needed.
• Effectively managing 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; collecting patient payment responsibility and accurately preparing end of day reporting or payment reconciliation as needed.
• Escalating billing inquiries as needed.
• Accurately scheduling patient appointments. Successful scheduling includes, but is not limited to, exhibiting proficiency in appointment scheduling procedures, accurate documentation and routing of messages, scheduling and confirming appointments according to practice guidelines, entering appropriate insurance, performing key user duties with minimal errors.
• May be responsible for initiating and validating referrals/authorizations.
• Regularly displaying a proactive approach to customer service by listening to the patient, taking ownership of solutions and being able to accurately identify the need to involve leadership in order to resolve concerns.

This is a benefitted Full Time (40 hours per week), Day Shift position with a varied schedule and eight hour shifts which include some weekends and holidays, located at Scripps Memorial La Jolla.

*Required Qualifications: *

• Must be able to demonstrate proficiency of computer applications, excellent mathematical skills and ability to handle monies.
• Excellent communication and customer service skills.
• Strong organizational and analytical skills; innovative with ability to identify and solve problems.

Preferred Qualifications:

• 1 year of experience in a customer service or healthcare/medical office environment preferred.
• Able to adapt, prioritize and meet deadlines.
• Knowledge of medical terminology, commercial and government health insurance and billing guidelines, ACA requirements, understanding of DRG's, Medical ICD9/ICD10 codes and CPT/HCPC Codes and Modifiers.

Job: *Business Office

Organization: *Scripps La Jolla Hospital

Title: Patient Service Representative - Case Management

Location: Central San Diego County-LA JOLLA-SCRIPPS MEMORIAL HOSPITAL LA JOLLA

Requisition ID: 232008127