Senior Clinic Operations Representative - Northern Virginia - Hamaker Court

Kids Are Our Everything.

Department

Pay Range

About the Role:

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.

What You’ll Bring:

Minimum Education

• High School Diploma or GED (Required)

• Associate’s degree (Preferred)

Minimum Work Experience

3 year’s 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 appointments 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-payment, deposits, payment in full, or past due balance collections with parents prior to scheduled appointment in a professional & courteous manner.

• Counsel parents or refer parents 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: 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.

• 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: Activity should be completed 3-4 days in advance of clinic 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 3-4 days in advance of clinic session; Areas with procedures requiring authorizations work standard may be 5-7 days.

• 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: Activity should be completed 3-4 days in advance of ancillary session; Work standard may be 5-7 days for areas with procedures requiring authorization.

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 P AR staff (may conduct training sessions); Provide workflow 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. May work returned mail as needed.

• All staff are responsible for information distributed via e-mail. Staff should check work emails a minimum of 3 times daily and respond to inquiries within 24 hours (or next business day).

• Maintain office files and office supplies at PAR levels.

• Maintain clean reception area and workspace.

• Other support as needed.

Benefits That Support You:

• Comprehensive health coverage, including medical, prescription, infertility, and transgender health services.

• Generous paid time off, including vacation accrual from day one, sick leave, holidays, and a personal day.

• Financial wellness support, including a 401(k) plan and healthcare and dependent care spending accounts.

• Employer-paid life, AD&D, and long-term disability coverage, with optional supplemental plans.

• Additional perks, including tuition assistance, fitness resources, employee assistance, commuter benefits, and more.

Why Join Us:

• Nationally Recognized Excellence – Consistently ranked among the Top 10 Children’s Hospitals in the nation by U.S. News & World Report.

• Leading Pediatric Care – One of the largest and most comprehensive children’s hospitals in the country, offering nationally ranked specialties and cutting-edge treatments.

• Innovation & Research – A premier academic medical center with a strong commitment to pediatric research, education, and advancing the future of child health.

• Mission-Driven Culture – Dedicated to providing family-centered care while fostering a collaborative, supportive environment for clinical teams.

The disclosed salary range includes the minimum and maximum rates within which Children’s National believes an individual’s base pay rate will fall for this position. It is not typical for an individual to be hired at or near the maximum of the pay range. The exact pay rate for this position will be based on a variety of factors in alignment with the Children’s National compensation philosophy. These factors are legitimate and non-discriminatory including, but not limited to, the current market conditions; organizational needs; the individual’s combination of prior work experience, level of education, knowledge, skills, and other qualifications. Children’s National is committed to providing a fair and competitive total rewards package to each of our employees. This base salary range does not include our comprehensive benefits package or any additional compensation for which this position may be eligible.

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. The “Know Your Rights” poster is available here: and the pay transparency policy is available here: Know Your RightsPay Transparency Nondiscrimination Poster.

Please note that it is the policy of Children's National Hospital to ensure a “drug-free” work environment: a workplace free from the illegal use, possession or distribution of controlled substances (as defined in the Controlled Substances Act), or the misuse of legal substances, by all staff (management, employees and contractors). Though recreational and medical marijuana are now legal in the District of Columbia, Children's National and its affiliates maintain the right, in accordance with our policy, to enforce a drug-free workplace, including prohibiting recreational or prescribed marijuana.