Patient Service Specialist - Case Management - La Jolla

Primary Duties

• 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 necessary for accurate registration including assigning appropriate Medical Record Number, referral/authorization, point of service payment collection, document collection and arrival/check-in functions
• Receive and route messages received in the department appropriately and manage customer billing and payment inquiries as needed
• Manage the patient check-in and check-out process from start to finish, including 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
• Assist patients with HPE eligibility, discussing payment arrangement options including financial assistance information, providing price estimates
• Regularly display 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 to resolve concerns
• Act as a member of the patient care team by supporting the clinical care staff in the care of the patient

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
• Able to adapt, prioritize and meet deadlines

Preferred Qualifications

• 2 years of experience in customer service or healthcare/medical office environment
• 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