CareHub Specialist / Patient Service Specialist - Case Management

This is a Full-Time position (80 hours per pay period) with eight-hour day shifts from Monday - Friday, located at our Scripps Mercy Hospital in Hillcrest. You will enjoy comprehensive benefits that cover health & wellness, career development, and retirement options among other benefits.

Why join Scripps Health?

At Scripps Health, your ambition is empowered and your abilities are appreciated:

• Nearly a quarter of our employees have been with Scripps Health for over 10 years.
• Scripps is a Great Place to Work Certified company for 2026.
• Scripps Health has been consistently ranked as a top employer for women, millennials, diversity, and as an overall workplace by various national publications.
• Becker’s Healthcare ranked Scripps Health on its 2026 list of 150 top places to work in health care.
• We have transitional and professional development programs to create a learning environment that enables you to thrive in your specific field as well as in your overall career.
• Our specialties have been nationally recognized for quality in areas such as cardiovascular care, oncology, orthopedics, geriatrics, obstetrics and gynecology, and gastroenterology.

The CareHub Specialist coordinates post-acute referrals, authorizations, insurance verification, and discharge support to facilitate timely, appropriate, and efficient transitions of care. The role manages referrals and payer processes across multiple systems, coordinates with post-acute providers and health plans, ensures required documentation is complete and accurate, and addresses barriers that may delay placement or discharge.

Key Accountabilities:

•    Coordinate post-acute referrals and placement across SNF, rehabilitation, home health, hospice, home infusion, LTAC, DME, transportation, dialysis, and community services.
•    Manage authorizations, payer communications, appeals, extensions, and modifications while ensuring timely and accurate documentation.
•    Verify insurance benefits and provider network participation and coordinate Managed Medi-Cal and other coverage-related referrals.
•    Serve as a liaison between Case Management, Social Work, patients/families, payers, and post-acute providers to resolve discharge barriers.
•    Maintain proficiency in Epic, ECIN/CarePort, payer platforms, and related systems while supporting process improvement, regulatory compliance, timely discharge, and reimbursement.
 

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 Code.