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Providence Patient Care Representative III in Santa Monica, California


Providence is calling a Patient Care Representative III (Full time/Day shift) at our Providence Saint Johns Medical Foundation in Santa Monica, CA.

We are seeking a Patient Care Representative III who will be responsible for patient management, the flow of patients through the front office in an efficient and professional manner, the accurate coding of services rendered, over the counter cash management, verifying and communicating insurance and demographic information, extensive knowledge of the practice management system, including formatting, scheduling matrix, and inventory management.

In this position you will:

  • Answer phones promptly. Screen and direct phone calls appropriately. Timely response to routine inquiries. Take accurate and complete messages (100% of the time) and forwards messages promptly and accurately

  • Schedule patients in a timely and accurate manner

  • Complete patient check-in process. This includes:

  • Ensure patients sign the sign-in sheet

  • Verify/update or has patient complete new Patient Registration Form

  • Collect and ensure accurate insurance and demographic information

  • Copy insurance card

  • Initial Patient Registration Form and superbill to confirm completeness of insurance information

  • Collect patient copayments

  • Complete patient checkout process. This includes:

  • Maximizing collections by following department policies and procedures

  • Reviewing the patient superbill for completeness of services rendered, diagnosis, follow-up instructions and scheduling next appointment or completing patient recall card

  • Complete authorizations as directed by the insurance requirements and the physician/provider. Maintain authorization log and notify patient of receipt of authorization within twenty-four hours. Notify physician/provider within 24 hours of any denials

  • Maintaining an orderly and pleasing work space that ensures the integrity and safety of the practice, patients and personnel

  • Responsible for accurate coding and batching of services rendered. Prepare paperwork, including accurate completion of Batch Summary Form (95% of the time) and submits within forty-eight hours the completed required information to the Central Billing Office

  • Responsible for maximizing collection of all over the counter payments due at time of service. This may include copayments, deductibles, uninsured and patient balances. Manage received cash by adhering to the department policy and procedure on cash control

  • Responsible for maintaining and documenting an appropriate inventory of front office supplies

  • Has substantial knowledge of practice management information system, can review and understand patient profile summaries, make entries to receivable program and format scheduling matrices

  • Responsible for timely and accurate verification of patient insurance and demographic information and ensures the communication of this information to the appropriate staff

  • Maintaining an orderly and pleasing work space that ensures the integrity and safety of the practice, patients and personnel

  • Scan and link text/images in Electronic Medical Record

  • Serve as liaison with employers for worker’s compensation and employer bulk and MILCM, to facilitate workflow and customer service

  • Responsible for completing worker’s compensation first reports and status reports

  • Responsible for reporting status of diagnostic/specialty services ordered by rendering physician at the site in a timely manner, as specified by supervisor

  • Responsible for the coordination and oversight of Employer Bulk Accounts and the work is completed timely and accurately

  • Responsible for completing specialty services batching accurately and timely

  • Responsible for “Rounding with Purpose” and being the Patient Advocate

  • Documentation/Information Management: Utilize MIS systems according to policy and procedure. Appropriate care and maintenance of MIS system needs to be observed at all times

  • Development: Keep abreast of department policies and procedures by positively participating in staff meeting and inservices (minimum of 8/year)

  • Performance Improvement: Participate in CQI and/or quality management activities as identified by supervisor

  • Budgetary: Responsible to use equipment and supplies efficiently and to make suggestions for cost cutting initiatives to supervisor as needed


Required qualifications for this position include:

  • 3 years experience in medical office

  • Knowledge of ICD-9 / CPT Coding

  • Able to use Microsoft Office Suite

  • Typing / keyboarding skills 45 WPM

About the location you will serve:

Providence Health & Services is further developing its physician integration strategy. As part of this growth, Providence Saint John’s Medical Foundation came into flourishing. Saint John’s Medical Foundation is an integrated, not-for-profit network of medical clinics and affiliated services, servicing the greater Santa Monica and Los Angeles area. The Foundation is expected to continue to grow in the next several years, bringing with it facilities, staff and physician growth to support that objective.

For information on our comprehensive range of benefits, visit:

Our Mission

As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.

About Us

Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Patient Services

Location: California-Santa Monica

Req ID: 270867