Clinic Operations Representative - Sr. Clinic Operations Representative, Multiple Locations VA, MD, DC (EVERGREEN)

Children's National Medical Center
9,062.40
medical insurance
United States, D.C., Washington
Oct 22, 2024
Description We are currently hiring Clinic Operations Representatives and Sr. Clinic Operations Representatives for multiple locations at Ambulatory Services clinics for Children's National Hospital: Virginia Fairfax: 3023 Hamaker Court, Suite 300, Fairfax, VA 22031 Maryland Rockville: 9850 Key West Avenue, 2nd Floor, Rockville, MD 20850 Silver Spring (Tech Hill): 12211 Plum Orchard Drive, Silver Spring, MD 20904 Silver Spring: 1 Inventa Place, Silver Spring, MD 20910 Washington, DC Children's National Main Hospital: 111 Michigan Avenue NW, Washington, DC 20010 Takoma-DC- 6833 4th Street NW, Washington, DC 20012 The Clinic Operations Representative reports to the Clinic Operations Supervisor or Clinic Operations/Practice Manager. Provide patient services and administrative support in clinic operations. Interacts with parents, patients, physicians and other staff under moderate supervision in a courteous manner. Provide assistance to other employees within their department as well as other departments. Collect and verify all demographic information to ensure accuracy. May provide required notification of scheduled services according to managed care requirements. May be responsible for scheduling patients for specialty appointments. The Senior Clinic Operations Representative reports to the Clinic Operations Manager or Practice Manager. Responsible for ensuring workflow in the clinic. Expected to triage resource issues in clinic and involve supervisor or manager as needed. Aid the department in meeting financial objectives. Provide training and mentoring to other employees within their department as well as other departments. Able to perform all the functions of a COR. Position may be required to float to other clinics or ROCS for coverage. Position geared to support single specialty ambulatory clinic. Next step in career ladder is Team Lead. Qualifications Clinic Operations Representative Minimum Education High School Diploma or GED (Required) Minimum Work Experience 1 year Experience performing billing, patient registration, and scheduling, medical insurance verification, insurance screening. (Required) Required Skills/Knowledge Broad clinic knowledge, customer service skills. Computer knowledge necessary. Microsoft Office experience preferred (Word & Excel). Complete Ambulatory Services training curriculum and pass all competency assessments, including a mock clinic. The ability to type minimum of 35 words per minute required. Functional Accountabilities Patient Services Demonstrate accuracy of scheduling patients using the applicable scheduling system for the department. Complete computer aided, on-line registration screen with parent/guardian via telephone or in person in professional & courteous manner. Collect accurate demographic and insurance information. Update systems as needed in accordance with department standards for registration accuracy. Reschedule appointment for patients who did not show or for the ancillary services cancellations by providers/technologist. Schedule follow up appointments at check out if applicable. Greet patients and parents courteously. Arrive patient in appropriate system based on department policy. Obtain required consents for department & ensure distribution of compliance related materials (i.e. HIPPA Privacy Notice, Patient Rights). Obtain copy of insurance card and photo ID to be stored in medical record (copy or scan activity required). Ensure applicable insurance company and CNMC HIM department receive copies of appropriate forms/documentation. Complete all documentation in accordance with department policy and procedure. Respond to patient portal work lists (i.e. appointment requests, fax queues, email requests, etc. May include messaging center work lists in the future). Information Verification Verify insurance eligibility using applicable eligibility system. Ensure managed care carve outs (lab and radiology carve outs) are adhered to. Notify parents of the need for completed insurance referral form or pre-authorization prior to scheduled/unscheduled appointments. Discuss co-payment, deposits, payment in full, or past due balance collections with parents prior to scheduled appointment in a professional & courteous manner. Counsel parents or refer parent to Financial Information Center (FIC) for establishing payment schedule or method of payment. Verify insurance information is complete prior to procedure and collect and verify pre-authorization/referral information: goal is to obtain authorizations 5 days in advance of service. Utilize all systems where patient information may be stored (EPRS, SCI, Cerner, IDX, McKesson, etc.) to verify that systems are in sync Cash Collection Collect and record co-payments, deposits and payments in full and provide payer with receipt. Responsible for helping department meet 85% of the collection target for the department. Maintain departmental requirements regarding cash controls and collections. Billing Preparation Reconcile schedules for upcoming clinic session to include ensuring that accounts are set up for billing and services requiring authorization are flagged: Activity should be completed 3-4 days in advance of clinic session; Areas with procedures requiring authorizations work standard may be 5-7 days. Appropriately clear all walk-in and ensure scheduled/unscheduled appointments are linked to scheduling system. Office Support Answer telephone and address caller needs appropriately. Avoid transferring calls for better service to families. Meet department standards relative to ACD policies if applicable. Manage voice mail messages within same business day. Distribute mail. May work returned mail as needed. All staff are responsible for information distributed via e-mail. Staff should check work email a minimum of 3 times daily and respond to inquiries within 24 hours (or next business day). Maintain office files and office supplies at P AR levels. Maintain clean reception area and workspace. Other support as needed. Safety Speak up when team members appear to exhibit unsafe behavior or performance Continuously validate and verify information needed for decision making or documentation Stop in the face of uncertainty and takes time to resolve the situation Demonstrate accurate, clear and timely verbal and written communication Actively promote safety for patients, families, visitors and co-workers Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance Organizational Accountabilities Organizational Accountabilities (Staff) Organizational Commitment/Identification Anticipate and responds to customer needs; follows up until needs are met Teamwork/Communication Demonstrate collaborative and respectful behavior Partner with all team members to achieve goals Receptive to others' ideas and opinions Performance Improvement/Problem-solving Contribute to a positive work environment Demonstrate flexibility and willingness to change Identify opportunities to improve clinical and administrative processes Make appropriate decisions, using sound judgment Cost Management/Financial Responsibility Use resources efficiently Search for less costly ways of doing things Safety Speak up when team members appear to exhibit unsafe behavior or performance Continuously validate and verify information needed for decision making or documentation Stop in the face of uncertainty and takes time to resolve the situation Demonstrate accurate, clear and timely verbal and written communication Actively promote safety for patients, families, visitors and co-workers Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance Full-Time Salary Range -Clinic Operations Representative: $39,062.40 - $76,502.40 Senior Clinic Operations Representative Minimum Education High School Diploma or GED (Required) Associate's Degree (Preferred) Minimum Work Experience 3 years Experience performing billing, patient registration, scheduling, medical insurance verification, insurance screening. (Required) Required Skills/Knowledge Broad clinic knowledge, customer service skills. Computer knowledge necessary. Microsoft Office experience preferred (Word & Excel). Complete Ambulatory Services training curriculum and pass all competency assessments, including a mock clinic. The ability to type minimum of 35 words per minute required. Functional Accountabilities Patient Services Ensure accuracy of scheduling patients using the applicable scheduling system for the department. Complete computer aided, on-line registration screen with parent/guardian via telephone or in person in professional & courteous manner. Collect accurate demographic and insurance information. Update systems as needed in accordance with department standards for registration accuracy. Updates scheduling systems with cancellation and no shows by COB. Reschedule appointment for patients who did not show or for clinic cancellations by providers. Schedule follow up appointments at check out if applicable. Able to open and close schedules as needed. Greet patients and parents courteously. Arrive patient in appropriate system based on department policy . Obtain required consents for department & ensure distribution of compliance related materials (i.e. HIPPA Privacy Notice, Patient Rights). Obtain copy of insurance card and photo ID to be stored in medical record (copy or scan activity required). Ensure applicable insurance company and CNMC HIM department receive copies of appropriate forms/documentation. Complete all documentation in accordance with department policy and procedure. Collect and record co-payments, deposits and payments in full and provide payer with receipt: Responsible for helping department meet 85% of the collection target for the department. Respond to patient portal work lists (i.e. appointment requests, fax queues, email requests, etc. May include messaging center work lists in the future). Information Verification Verify insurance eligibility using applicable eligibility system. Ensure managed care carve outs (lab and radiology carve outs) are adhered to. Notify parents of the need for completed insurance referral form or pre-authorization prior to scheduled/unscheduled appointments. Discuss co-payment, deposits, payment in full, or past due balance collections with parents prior to scheduled appointment in a professional & courteous manner. Counsel parents or refer parent to Financial Information Center (FIC) for establishing payment schedule or method of payment. Verify insurance information is complete prior to procedure and collect and verify pre-authorization/referral information: Goal is to obtain authorizations 5 days in advance of service; Interface with insurance companies as needed; Document activity in "account notes" following standards set by department. Utilize all systems where patient information may be stored (EPRS, SCI, Cerner, IDX, McKesson, etc.) to verify that systems are in synch. Billing Preparation & Daily Reconciliation Reconcile schedules for upcoming clinic session to include ensuring that accounts are set up for billing and services requiring authorization are flagged: Activity should be completed 3-4 days in advance of clinic session; Areas with procedures requiring authorizations work standard may be 5-7 days. Review and print clinic schedules, ensure appropriateness of scheduled appointments and back fill open slots: Activity should be completed 3-4 days in advance of clinic session; Areas with procedures requiring authorizations work standard may be 5-7 days. Verify that families received automated appointment reminder calls and ensures manual confirmations are completed for those that failed the automated messaging: Activity should be completed 3-4 days in advance of clinic session; Areas with procedures requiring authorizations work standard may be 5-7 days. Maintain departmental requirements regarding cash controls and deposits. Reconcile daily cash receipts/collections and submit to manager. Reconcile charge capture against schedules. Ensures that quality registration work queues are addressed timely: Activity should be completed 3-4 days in advance of ancillary session; Work standard may be 5-7 days for areas with procedures requiring authorizations. Performance Improvement, Mentoring and Training Work with manager to reduce registration and authorization denials. Work with manager to research and resolve missing charges. Provide input to manager about registration errors for ongoing training purposes: Monitor & correct registration errors; Monitor QA reports to identify training needs & ensure standards are met. Provide expertise to peers throughout the institution: Train & mentor P AR staff (may conduct training sessions); Provide work flow guidance. Office Support Answer telephone and address caller needs appropriately. Avoid transferring calls for better service to families. Meet department standards relative to ACD policies if applicable. Manage voice mail messages within same business day . Distribute mail. May work returned mail as needed. All staff are responsible for information distributed via e-mail. Staff should check work email a minimum of 3 times daily and respond to inquiries within 24 hours (or next business day). Maintain office files and office supplies at P AR levels. Maintain clean reception area and work space. Other support as needed. Organizational Accountabilities Organizational Accountabilities (Staff) Organizational Commitment/Identification Anticipate and responds to customer needs; follows up until needs are met Teamwork/Communication Demonstrate collaborative and respectful behavior Partner with all team members to achieve goals Receptive to others' ideas and opinions Performance Improvement/Problem-solving Contribute to a positive work environment Demonstrate flexibility and willingness to change Identify opportunities to improve clinical and administrative processes Make appropriate decisions, using sound judgment Cost Management/Financial Responsibility Use resources efficiently Search for less costly ways of doing things Safety Speak up when team members appear to exhibit unsafe behavior or performance Continuously validate and verify information needed for decision making or documentation Stop in the face of uncertainty and takes time to resolve the situation Demonstrate accurate, clear and timely verbal and written communication Actively promote safety for patients, families, visitors and co-workers Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance Full-Time Salary Range Sr. Clinic Operations Representative : $42,224 - $82,430.40 Primary Location : District of Columbia-Washington Other Locations : Maryland-Annapolis, District of Columbia-Washington, Maryland-Rockville, Maryland-Lanham, Virginia-Fairfax, Maryland-Fulton, Maryland-Silver Spring Work Locations : CN Hospital (Main Campus) 111 Michigan Avenue NW Washington 20010 Job : Administrative Support / Customer Service Organization : Ambulatory Shift : Day Work Schedule : Day Job Posting : Aug 19, 2024, 4:55:33 PM