Scripps Health · 11 hours ago
Patient Account Specialist - PFS Billing Services
San Diego, CA
Full-time
Onsite
Entry, Mid Level
$26.45/hr - $34.33/hr
2+ years expScripps Health is a respected healthcare organization that supports a variety of medical facilities and employs a large team of healthcare professionals. The Patient Account Specialist role focuses on managing hospital billing documents and ensuring accurate follow-up with insurance carriers, patients, and healthcare providers. This position requires strong organizational skills and a commitment to providing excellent customer service in a fast-paced environment.
AssociationFitnessHealth CareHospitalMedicalNon Profit
Hiring Manager
Jessica Saunders, RACR, RACS
Responsibilities
Responsible for working aged reports and credit balances on a regular basis set by department guidelines
Follows-up with insurance carriers timely on unpaid claims until claims are paid or only self-pay balance remains. Does not have claims written off for timely filing
Processes rejections by either making accounts self-pay and generating a letter of rejection to patient or correct any billing error and resubmitting claims to insurance carriers
Keeps updated on all billing requirements and changes for all insurance types
Responsible for responding to all inquiries, billing denials, other correspondence and phone requests in an efficient, timely, and effective manner. Secures needed medical documentation required or requested by insurances
Works with HIM staff to ensure that complete diagnosis/procedure codes and modifiers are reported to insurance carriers as required
Working directly with the insurance company, healthcare provider, liable third parties, and patient to get a claim processed and paid
Works to help maintain Accounts Receivable (AR) days at or near target level set by the Hospital Senior Team
Supporting continuous improvement of organization processes and personal knowledge and skills, and maintaining and protecting confidential information
Providing excellent customer service through cooperative working relationships, and meeting productivity and quality standards
Qualification
Required
Strong working knowledge of managed care plans, insurance carriers, government Payers and payer requirements
Knowledge of Medical Terminology and Medicare Compliance
Familiarity with HIPAA privacy requirements for patient information
Basic understanding of DRG's, Medical ICD9/ICD10 codes and CPT/HCPC Codes
Ability to multitask and stay organized
Good verbal and written communication skills
Detail oriented and ability to prioritize work
Requires a moderate level of interpersonal, problem solving, and analytic skills
Knowledgeable on insurance and reimbursement process
Ability to establish/maintain cooperative working relationships with staff, Medical Staff and providers
Preferred
Two years of patient accounts experience in a healthcare setting
Working knowledge of healthcare EPIC software preferred
Minimum two year experience billing Medicare, Medicaid, Blue Cross and Commercial insurance preferred, three or more years desired
Knowledge in Excel, Word and basic computer functions such as saving documents, sharing documents
Demonstrate strong computer skills required. (Education may be substituted for experience in some areas.)
Demonstrate knowledge of accounts receivable practices, payer billing and reimbursement procedures and practices
Working knowledge of hospital UB04, CPT-4, HCPCS, ICD-10 and Revenue codes
Proficient in institutional insurance billing guidelines using 837I X12 Version 005010X279A1 transactions
Company
Scripps Health
Scripps Health is a nonprofit health care system based in San Diego, California.
10001+ employees
H1B Sponsorship
Scripps Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (3)
2024 (2)
2023 (7)
2022 (1)
2021 (2)
2020 (4)
Funding
Current Stage
Late StageTotal Funding
$0.44MKey Investors
National Institutes of HealthHearst Foundations
2024-12-05Grant· $0.32M
2022-01-19Grant· $0.12M
Leadership Team
Clark Kegley
Chief Technology Officer
Recent News
2026-01-14
2025-11-08
TeamBest Global Companies
2025-11-07
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