Sr. Clinic Operations Representative

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. Position may be required to float to other clinics or ROCS for coverage. Position geared to support single specialty ambulatory clinic. Next step in career ladder is Team Lead.

A strong background in obtaining insurance authorization is preferred.

Minimum Education
High School Diploma or GED (Required)

Associate's Degree (Preferred)
Minimum Work Experience
3 years of experience performing billing, patient registration, scheduling, medical insurance verification, insurance screening. (Required)

Required Skills/Knowledge
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.

Functional Accountabilities
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. Update systems as needed in accordance with department standards for registration accuracy.
• Updates 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.
• 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: Responsible for helping department meet 85% of the collection target for the department.
• 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 (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-