Clinical Operations Representative
Resume:
Tia
Blake
**** ******** **, ********, ** *****
adup19@r.postjobfree.com
Administrative Healthcare Professional with 15+ years of experience assisting with and fulfilling organization staffing needs and requirements. A proven track record of using my excellent personal, communication and organization skills to lead and improve HR departments, recruit excellent personnel, and improve department efficiencies. Team player with excellent communication skills, high quality of work, driven and highly self-motivated. Strong negotiating skills and business acumen and able to work independently.
Experience
2018 – PRESENT
Clinic Operations Representative/Children’s National Medical Center, Washington, DC
Provide patient services and administrative support in clinic operations. Interacts with parents, patients, physicians and other staff under moderate supervision in a courteous manner. Provide assistance to other employees within their department as well as other departments. Collect and verify all demographic information to ensure accuracy. Provide required notification of scheduled services according to managed care requirements. May be responsible for scheduling patients for specialty appointments. Position may be required to float to other clinics or ROCs for coverage. Demonstrate 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. Reschedule appointment for patients who did not show or for the ancillary services cancellations by providers/technologist. Schedule follow up appointments at check out if applicable. 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. Ensure applicable insurance company and CNMC HIM department receive copies of appropriate forms/documentation. Complete all documentation in accordance with department policy and procedure. Respond to patient portal work lists (i.e. appointment requests, fax queues, email requests, etc). 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 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: goal is to obtain authorizations 5 days in advance of service. Utilize all systems where patient information may be stored (EPRS, SCI, Cerner, IDX, McKesson, etc.) to verify that systems are in sync. 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. Maintain departmental requirements regarding cash controls and collections. Billing Preparation. 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. Appropriately clear all walk-in and ensure scheduled/unscheduled appointments are linked to 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 voice mail messages within same business day. Distribute mail. Staff should check work email a minimum of 3 times daily and respond to inquiries within 24 hours (or next business day). Maintain office files and office supplies at P AR levels. Maintain clean reception area and workspace. Other support as needed. Speak up when team members appear to exhibit unsafe behavior or performance. Continuously validate and verify information needed for decision making or documentation. 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. Anticipate and responds to customer needs; follows up until needs are met. Demonstrate collaborative and respectful behavior. Use resources efficiently.
JUNE 2012 – AUGUST 2014
Office Manager/Pathways to Housing DC -DC Superior Court, Washington, DC
Assisted in recruitment outreach to prospective employees. Organized and conducted several seminars for hospital employees to educate and update them regarding available employment benefit options. Arranged hospital-wide guest speakers symposia to educate management about new employment laws and workplace confidence and morale building techniques. Administrative tasks.
Skills
Type 96WPM • Proficient with Workday • Team player • Excellent time management skills • Conflict Management • Public Speaking • Data analytics
Education
MAY 2016
Associates of Health Information Technology/MedTech College, Washington, DC
Activities
Literature • Environmental conservation • Art • Yoga • Skiing • Travel
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