Senior Clinic Operations Representative - Northern Virginia - Hamaker Court

About the role

This position reports to the Clinic Operations Manager or Practice Manager. Responsible for ensuring work flow 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.

Responsibilities

• 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.
• Respond to patient portal work lists (i.e. appointment requests, fax queues, email requests, etc. May include messaging center work lists in the future).
• Verify insurance eligibility using applicable eligibility system.
• Notify parents of the need for completed insurance referral form or pre-authorization prior to scheduled/unscheduled appointments.
• Counsel parents or refer parents 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.
• 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.
• Reconcile schedules for upcoming clinic session to include ensuring that accounts are set up for billing and services requiring authorization are flagged.
• Review and print clinic schedules, ensure appropriateness of scheduled appointments and back fill open slots.
• Verify that families received automated appointment reminder calls and ensures manual confirmations are completed for those that failed the automated messaging.
• Maintain departmental requirements regarding cash controls and deposits.
• Reconcile daily cash receipts/collections and submit to manager.
• Reconcile charge capture against schedules.
• Ensure that quality registration work queues are addressed timely.
• Work with manager to reduce registration and authorization denials.
• 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 workflow guidance.

Requirements

• Minimum Education: High School Diploma or GED (Required)
• Minimum Work Experience: 3 years’ Experience performing billing, patient registration, scheduling, medical insurance verification, insurance screening. (Required)

Qualifications

• 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.

Skills

• Functional Accountabilities Patient Services
• Information Verification
• Billing Preparation & Daily Reconciliation
• Performance Improvement, Mentoring and Training

Benefits

Comprehensive health coverage, including medical, prescription, infertility, and transgender health services.
Generous paid time off, including vacation accrual from day one, sick leave, holidays, and a personal day.
Financial wellness support, including a 401(k) plan and healthcare and dependent care spending accounts.
Employer-paid life, AD&D, and long-term disability coverage, with optional supplemental plans.
Additional perks, including tuition assistance, fitness resources, employee assistance, commuter benefits, and more.