Clinic Operations Representative - PRN, Northern Virginia (Mon - Fri, Day Shift

About The Role – Provide patient services and administrative support in clinic operations. Reports to the Clinic Operations Supervisor or Practice Manager. Interacts with parents, patients, physicians, and staff in a courteous manner. Provides assistance to employees within the department and other departments. Collects and verifies all demographic information for accuracy. May provide required notification of scheduled services per managed care requirements, schedule patients for specialty appointments, float to other clinics or ROCs for coverage.

Next career step is Senior Clinic Operations Rep or Team Lead.

Coverage: up to 40 hours per week, Monday through Friday. Operating window 7:00 am to 6:00 pm (8.5‑hour shifts). Provides support at the Anne Arundel, Prince George’s and Howard County Clinics.

• High School Diploma or GED (Required)

• 1 year experience performing billing, patient registration, scheduling, medical insurance verification, insurance screening (Required)

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. Minimum typing speed of 35 words per minute.

• Demonstrate accurate scheduling using the applicable scheduling system.
• Complete computer‑aided online registration screen with parent/guardian via telephone or in person courteously.
• Collect accurate demographic and insurance information; update systems as needed.
• Reschedule appointments for patients who did not show or for ancillary services cancellations by providers/technologists. Schedule follow‑up appointments at check‑out when applicable.
• Greet patients and parents courteously. Arrange patient in appropriate system based on department policy.
• Obtain required consents for the department and ensure distribution of compliance materials (HIPAA Privacy Notice, Patient Rights).
• Obtain copy of insurance card and photo  be stored in medical record (copy or scan). Ensure appropriate insurance company and CNMC HIM department receive copies of relevant forms/documentation. Complete all documentation per policy.
• Respond to patient portal work lists (appointment requests, fax queues, email requests, etc.).

• Verify insurance eligibility using the applicable system. Ensure managed care carve‑outs are adhered to.
• Notify parents of the need for completed insurance referral forms 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 appointments in a professional manner.
• Counsel parents or refer to the Financial Information Center (FIC) for payment schedule or method of payment.
• Verify insurance information is complete prior to procedure and collect pre‑authorization/referral information; goal to obtain authorizations 5 days in advance of service.
• Use all systems (EPRS, SCI, Cerner, IDX, McKesson, etc.) to verify that systems are in sync.

• Collect and record co‑payments, deposits, and payments in full; provide payer with receipt. Responsible for helping department meet 85% of the collection target.
• Maintain departmental cash controls and collection requirements.

• Reconcile schedules for upcoming clinic sessions to ensure accounts are set up for billing and that services requiring authorization are flagged. Complete 3‑4 days in advance of the clinic session; for procedures requiring authorizations, work standard may be 5‑7 days.
• Appropriately clear walk‑in and ensure scheduled/unscheduled appointments are linked to the scheduling system.

• Answer telephone calls and address caller needs appropriately; avoid unnecessary transfers.
• Manage voicemail messages within the same business day; meet department standards relative to ACD policies if applicable.
• Distribute mail; collect returned mail as needed.
• Check work emails at least three times daily and respond within…