Clinic Operations Representative - PRN, Northern Virginia (Mon - Fri, Day Shift)

Patient Services

• Schedule 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.
• 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.

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.

Organizational Accountabilities

• 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.