Clinic Operations Representative - Northern Virginia

About the Role

This position 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. Position may be required to float to other clinics or ROCs for coverage.

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 and update systems as needed.
• Reschedule appointments for patients who did not show or for ancillary service cancellations.
• Schedule follow-up appointments at check out if applicable.
• Greet patients and parents courteously and arrive patient in appropriate system.
• Obtain required consents and ensure distribution of compliance related materials.
• Obtain copy of insurance card and photo ID to be stored in medical record.
• Respond to patient portal work lists.

Information Verification

• Verify insurance eligibility using applicable eligibility system.
• Ensure managed care carve outs are adhered to.
• Notify parents of the need for completed insurance referral form or pre-authorization.
• Discuss co-payment, deposits, payment in full, or past due balance collections with parents.
• Counsel parents or refer to Financial Information Center for payment schedule.
• Verify insurance information is complete prior to procedure and collect and verify pre-authorization/referral information.
• Utilize all systems where patient information may be stored to verify systems are in sync.

Cash Collection

• Collect and record co-payments, deposits and payments in full and provide payer with receipt.
• Help department meet 85% of the collection target.
• Maintain departmental requirements regarding cash controls and collections.

Billing Preparation

• Reconcile schedules for upcoming clinic session to ensure accounts are set up for billing and services requiring authorization are flagged.
• Clear all walk-ins and ensure scheduled/unscheduled appointments are linked to scheduling system.

Office Support

• Answer telephone and address caller needs appropriately.
• Manage voice mail messages within same business day.
• Distribute mail and work returned mail as needed.
• Check work emails a minimum of 3 times daily and respond within 24 hours.
• Maintain office files and office supplies at PAR levels.
• Maintain clean reception area and workspace.

Safety

• Speak up when team members appear to exhibit unsafe behavior or performance.
• Continuously validate and verify information needed for decision making or documentation.
• Demonstrate accurate, clear and timely verbal and written communication.
• Actively promote safety for patients, families, visitors and co-workers.
• Attend carefully to important details.