Patient Access Representative III - 139969

UC San Diego Health's Revenue Cycle department supports the organization's mission to deliver outstanding patient care and to create a healthier world — one life at a time. We are a diverse, patient-focused, high-performing team with a commitment to quality, collaboration, and continuous improvement that enables us to deliver the maximum standard of care to our patients. We offer challenging career opportunities in a fast-paced and innovative environment and we embrace individuals who demonstrate a deep passion for problem-solving and customer service.

About the role

Under the general guidance of the Access Manager, the Patient Access Representative III pre-registers, pre-admits, and admits patients by telephone and/or in person. This position will have interchangeable locations between Hillcrest, La Jolla, and East Campus Medical Centers based on business needs.

Responsibilities

• Efficiently collect accurate demographic information.
• Review and interpret complex insurance benefits, obtain prior authorizations, and provide patient estimates.
• Handle cash collections and interact with public assistance programs (e.g., Medi-Cal, CCS).
• Implement Medicare requirements and interact with physicians, office personnel, and other hospital personnel, units, and departments.
• Refer appropriate cases to internal and external sources to assist patients with discharge/post-hospital care.
• Interact with hospital departments such as Utilization Review and Patient Business Services to ensure correct and timely reimbursement.

Requirements

• A minimum of three (3) years of registration or medical front office experience or equivalent combination of education and experience.
• Thorough knowledge of third-party payers.
• Demonstrated knowledge of medical terminology.
• Excellent customer service skills.
• Highly proficient with MS Office applications (Excel, Word).
• Strong communication skills, with the ability to convey complex ideas clearly both verbally and in writing to audiences at all levels.
• Professionalism, credibility, commitment to high-quality standards, innovation, and accountability.
• Ability to interact effectively with the public, including patients, visitors, clinical, and support staff.

Preferred Qualifications

• Patient Access experience in a hospital setting.
• UC San Diego - Extended Studies Intensive Revenue Cycle Course Certificate.
• Experience with insurance and authorization verification.
• Strong knowledge of third-party payors including federal, state, and private health plans.
• Bilingual English/Spanish.
• Knowledge and articulation of hospital patient forms, as required by JACAHO/GAD, etc.
• Prior cash handling experience.
• Experience completing birth certificates.

Special Conditions

• Must be able to work various hours, days, shifts, on-call, and at various locations based on the 24-hour Medical Center's business needs.
• Employment is subject to a criminal background check and pre-employment physical.

Pay

Hiring Pay Scale: $27.49 - $34.17 per hour.

Annual Full Pay Range: $60,865 - $80,304 (prorated if the appointment percentage is less than 100%). Hourly Equivalent: $29.15 - $38.46.

Factors in determining the appropriate compensation for a role include experience, skills, knowledge, abilities, education, licensure and certifications, and other business and organizational needs.

Schedule

70% appointment (28 hours per week).

Work schedule: Days, variable shifts.