Multi Specialty Customer Operations Representative

Jun 16, 2021
Jun 26, 2021
Full Time
This position reports to the Clinical Operations Manager or Practice Manager. Expected to triage resource issues in clinic and involve supervisor or manager as needed. Must be able to perform all functions of a clinic operations representative using multiple platforms of electronic health records and patient scheduling systems. Responsible for providing comprehensive information services and assistance to patients, parents, guardians and visitors who access health services at THEARC directly.

This position requires: courteous communication with the families and clinical staff; scheduling appointments on multiple systems; patient registration, insurance verification/authorization; relevant software experience (dental and medical) as well as perform other general front office duties as assigned.

This position provides assistance to other team members within the facility, including other departments operating at THEARC. Collects and verifies all demographic information to ensure accuracy and documents information in all relevant electron health record systems. Responsible for scheduling patients for both medical and dental specialty appointments. Position requires rotating between phone, front desk and chart prep.


Minimum Education
High School Diploma or GED (Required)

Minimum Work Experience
2 years related experience in physician office/ hospital clinical setting. Experience performing billing, patient registration, and scheduling, dental and medical insurance verification.

Required Skills/Knowledge
Broad dental & or medical clinic knowledge, customer service skills and of general administrative and clerical procedures. Ability to type a minimum of 35 words per minute is required. Must possess excellent customer service skills and the ability to resolve problems and respond to complaints in a positive, productive manner.

Functional Accountabilities
Patient Services
  • Demonstrate and ensure accuracy of scheduling patients using the applicable scheduling system for the encounter
  • Complete computer aided, on-line registration screen with parent/guardian via telephone or in person in a professional and courteous manner
  • Collect accurate demographic and insurance information. Update systems as needed in accordance with standards for registration accuracy
  • Reschedule appointments for patients who did not show or for the ancillary services cancellations by providers/extenders. Schedule follow up appointments at check out.
  • Greet patients and parents/guardians courteously. Arrive patient in appropriate system based on department policy.
  • Obtain required consents for department and 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 and dental record. Ensure applicable insurance company and CNHS HIM department receive copies of appropriate forms/documentation. Complete all documentation in accordance with institution policy and procedures.
  • 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 are adhered to
  • Notify parents of the need for complete insurance referral form or pre-authorization form prior to scheduled/unscheduled appointments
  • Discuss co-payment, deposits, payment in full, or past due balance collections with parents/guardians prior to scheduled appointment in a professional and courteous manner
  • Counsel parents or refer parent to Financial Information Center 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; interface with insurance companies as needed; Document activity in "account notes" following standards
  • Utilize all systems where patient information is stored (Cerner, Dentrix, eCW, etc) to verify that systems are in sync.
Customer Service
  • Act as a liaison between patients, families, staff and THEARC
  • Demonstrate, as a high priority, to place and service internal and external customers in a timely, courteous manner
  • Follow up until needs of the customer are met
Billing Preparation and Daily Reconciliation
  • Reconcile 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 2-4 days in advance of clinical session; areas with procedures requiring authorizations work standard may be 5-7 days
  • Review 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
  • Verify that families received automated appointment reminder calls and ensures manual confirmations are completed for those that failed the automated messaging: Activity should be completed 2-4 days in advance of clinical session; areas with procedures requiring authorizations work standard may be 5-7 days
  • Maintain requirements regarding cash controls and deposits. Reconcile daily cash receipts/ collections and submit to operations manager
  • Reconcile charge capture against schedules
  • Ensures that quality registration work queues are addressed timely: Activity should be completed 2-4 days in advance of clinical session; areas with procedures requiring authorizations work standard may be 5-7 days
  • Appropriately clear all dental emergency walk in's and ensure scheduled/unscheduled appointments are recorded into the scheduling system.
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 voicemail messages within same business day
  • All staff are responsible for information distributed via email. Staff should check work email a minimum of 3 times daily and respond to inquiries within 24 hours (or next business day)
  • Maintain clean reception area and work space
  • Other support as needed

Organizational Accountabilities
Organizational Accountabilities (Staff)
Organizational Commitment/Identification
  • Anticipate and responds to customer needs; follows up until needs are met

  • 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

  • Speak up when team members appear to exhibit unsafe behavior or performance
  • Continuously validate and verify information needed for decision making or documentation
  • Stop in the face of uncertainty and takes time to resolve the situation
  • Demonstrate accurate, clear and timely verbal and written communication
  • Actively promote safety for patients, families, visitors and co-workers
  • Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance

Childrens National Hospital is an equal opportunity employer that evaluates qualified applicants without regard to race, color, national origin, religion, sex, age, marital status, disability, veteran status, sexual orientation, gender, identity, or other characteristics protected by law.

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