Sr Clinic Ops Rep bei CNMC

%3Cb%3EMinimum Education%3C/b%3E%3Cbr/%3EHigh School Diploma or GED (Required)%3Cbr/%3EAssociate%27s Degree (Preferred)%3Cbr/%3E%3Cbr/%3E%3Cb%3EMinimum Work Experience%3C/b%3E%3Cbr/%3E3 years Experience performing billing, patient registration, scheduling, medical insurance verification, insurance screening. (Required)%3Cbr/%3E%3Cbr/%3E%3Cb%3ERequired Skills/Knowledge%3C/b%3E%3Cbr/%3EBroad clinic knowledge, customer service skills. Computer knowledge necessary. Microsoft Office experience preferred (Word %26 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.%3Cbr/%3E%3Cbr/%3E%3Cb%3EFunctional Accountabilities%3C/b%3E%3Cbr/%3E%3Cb%3EPatient Services%3C/b%3E%3Cbr/%3E%3Cul%3E%3Cli%3EEnsure accuracy of scheduling patients using the applicable scheduling system for the department. %3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EComplete computer aided, on-line registration screen with parent/guardian via telephone or in person in professional %26 courteous manner. %3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3ECollect accurate demographic and insurance information. Update systems as needed in accordance with department standards for registration accuracy . %3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EUpdates 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. %3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EGreet patients and parents courteously. Arrive patient in appropriate system based on department policy . %3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EObtain required consents for department %26 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. %3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3ECollect 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. %3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3ERespond to patient portal work lists (i.e. appointment requests, fax queues, email requests, etc. May include messaging center work lists in the future). %3C/li%3E%3C/ul%3E%3Cb%3EInformation Verification%3C/b%3E%3Cbr/%3E%3Cul%3E%3Cli%3EVerify insurance eligibility using applicable eligibility system. Ensure managed care carve outs (lab and radiology carve outs) are adhered to. %3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3ENotify parents of the need for completed insurance referral form or pre-authorization prior to scheduled/unscheduled appointments. %3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EDiscuss co-payment, deposits, payment in full, or past due balance collections with parents prior to scheduled appointment in a professional %26 courteous manner. %3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3ECounsel parents or refer parent to Financial Information Center (FIC) for establishing payment schedule or method of payment. %3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EVerify 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. %3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EUtilize all systems where patient information may be stored (EPRS, SCI, Cerner, IDX, McKesson, etc.) to verify that systems are in synch. %3C/li%3E%3C/ul%3E%3Cb%3EBilling Preparation %26 Daily Reconciliation%3C/b%3E%3Cbr/%3E%3Cul%3E%3Cli%3EReconcile 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.%3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EReview 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.%3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EVerify 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.%3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EMaintain departmental requirements regarding cash controls and deposits. Reconcile daily cash receipts/collections and submit to manager.%3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EReconcile charge capture against schedules.%3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EEnsures 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.%3C/li%3E%3C/ul%3E%3Cb%3EPerformance Improvement, Mentoring and Training%3C/b%3E%3Cbr/%3E%3Cul%3E%3Cli%3EWork with manager to reduce registration and authorization denials. %3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EWork with manager to research and resolve missing charges. %3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EProvide input to manager about registration errors for ongoing training purposes: Monitor %26 correct registration errors; Monitor QA reports to identify training needs %26 ensure standards are met. %3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EProvide expertise to peers throughout the institution: Train %26 mentor P AR staff (may conduct training sessions); Provide work flow guidance. %3C/li%3E%3C/ul%3E%3Cb%3EOffice Support%3C/b%3E%3Cbr/%3E%3Cul%3E%3Cli%3EAnswer 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 . %3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EDistribute mail. May work returned mail as needed. %3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EAll 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). %3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EMaintain office files and office supplies at P AR levels. %3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EMaintain clean reception area and work space. %3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EOther support as needed. %3C/li%3E%3C/ul%3E%3Cbr/%3E%3Cb%3EOrganizational Accountabilities%3C/b%3E%3Cbr/%3E%3Cb%3EOrganizational Accountabilities (Staff)%3Cbr/%3EOrganizational Commitment/Identification %3C/b%3E %3Cul%3E%3Cli%3EAnticipate and responds to customer needs; follows up until needs are met%3C/li%3E%3C/ul%3E%3Cbr/%3ETeamwork/Communication %3Cul%3E%3Cli%3EDemonstrate collaborative and respectful behavior%3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EPartner with all team members to achieve goals%3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EReceptive to others’ ideas and opinions%3C/li%3E%3C/ul%3E%3Cbr/%3EPerformance Improvement/Problem-solving %3Cul%3E%3Cli%3EContribute to a positive work environment%3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EDemonstrate flexibility and willingness to change%3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EIdentify opportunities to improve clinical and administrative processes%3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EMake appropriate decisions, using sound judgment%3C/li%3E%3C/ul%3E%3Cbr/%3ECost Management/Financial Responsibility %3Cul%3E%3Cli%3EUse resources efficiently%3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3ESearch for less costly ways of doing things%3C/li%3E%3C/ul%3E%3Cbr/%3ESafety %3Cul%3E%3Cli%3ESpeak up when team members appear to exhibit unsafe behavior or performance%3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EContinuously validate and verify information needed for decision making or documentation%3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EStop in the face of uncertainty and takes time to resolve the situation%3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EDemonstrate accurate, clear and timely verbal and written communication%3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EActively promote safety for patients, families, visitors and co-workers%3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3EAttend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance%3C/li%3E%3C/ul%3E Jetzt bewerben