Senior Clinic Operations Representative - DC - Main Campus - Neurology/PM R/PT-OT Clinic; Full Time

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 and update systems as needed.
• Update 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.
• Open and close schedules as needed.
• Greet patients and parents courteously and arrive patient in appropriate system based on department policy.
• Obtain required consents and ensure distribution of compliance related materials (HIPAA Privacy Notice, Patient Rights).
• Obtain copy of insurance card and photo ID to be stored in medical record.
• 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 (appointment requests, fax queues, email requests, etc.).

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.
• 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.
• Interface with insurance companies as needed and document activity in account notes.
• 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.
• Review and print clinic schedules, ensure appropriateness of scheduled appointments and back fill open slots.
• Verify that families received automated appointment reminder calls and ensure 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.

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 PAR 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 and work returned mail as needed.
• Check work email a minimum of 3 times daily and respond to inquiries within 24 hours.
• Maintain office files and office supplies at PAR levels.
• Maintain clean reception area and work space.