Clinical Operations Representative Resume Example
I am a hard working, energetic, and reliable selfstarter who is looking to join a reputable firm, one that could benefit from an individual who is ready to give 110 percent. Bilingual professional assistance with experience in health care field. Throughout my career, I've been fortunate to represent quality merchandise and services and have learned just how to present them in their most favorable aspects. Along the way I have developed excellent interpersonal, organizational, and communication skills. I am definitely motivated by the knowledge that my earnings are directly related to the time energy, and effort that I commit to my position.
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This position 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 . May 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. Next step in career ladder is Senior Clinic Operations Rep or Team Lead position
Patient Services
1. Demonstrate accuracy of scheduling patients using the applicable scheduling system for the department.
2. Complete computer aided, on-line registration screen with parent/guardian via telephone or in person in professional & courteous manner.
3. Collect accurate demographic and insurance information. Update systems as needed in accordance with department standards for registration accuracy.
4. 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.
5. Greet patients and parents courteously. Arrive patient in appropriate system based on department policy.
6. 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.
7. 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
8. Verify insurance eligibility using applicable eligibility system. Ensure managed care carve outs (lab and radiology carve outs) are adhered to.
9. Notify parents of the need for completed insurance referral form or pre-authorization prior to scheduled/unscheduled appointments.
10. Discuss co-payment, deposits, payment in full, or past due balance collections with parents prior to scheduled appointment in a professional & courteous manner.
11. Counsel parents or refer parent to Financial Information Center (FIC) for establishing payment schedule or method of payment.
12. 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.
13. Utilize all systems where patient information may be stored (EPRS, SCI, Cerner, IDX, McKesson, etc.) to verify that systems are in sync.
Controls the flow of patient in and out of the clinic.
. Performs necessary registration functions to include insurance verifications, updating demographic information, and emergency contact information.
.Serves as both a receptionist and liaison between patients, teammates and staff.
. Reviews all client related forms for accuracy and completeness of information, assisting the client where necessary.
.Maintains a clean, organized, and safe working environment, Maintains files and or client database.
. Schedules appointments, records information, and effectively
communicates appointment schedule to client.
. Measures key metrics important for advanced access.
. Perform others duties assigned including outreach training through out the district.
. Performed Fisical analysis of funds; reported on findings to the seniors administrator for use in program planning, evaluation, and fiscal management.
.Utilized office automation to successfully accomplish clerical, statistical, and data entry assignment.
. Maintained open lines of communication between patients, physician, staff, and laboratory personnel.
. Routinely provided administrative support to the Health Center Manager and Health Center Supervisor.
Patient Care Coordinator
.Assist patients in scheduling appointments and managing health insurance issues.
.Identify and track patients discharged from the inpatient service or the emergency department.
.Utilize team-based communication strategies to close the loop on referrals, hospital follow-ups and any outstanding items identified in the patient's care plan.
.Identify which appointments may be made for patients before leaving the clinic and strive to get patients scheduled for those before they leave, mammogram and/or specialists.
.Resolves pre-certification, registration and case-related concerns prior to a patient's appointment.
.Assist patients in problem solving potential issues related to the health caresystem, financial or social barriers (e.g., request interpreters as appropiate
transportation services or prescription assistance).
.Maintain ongoing tracking and appropriate documentation on referrals to promote team awareness ansure patients safety.
.Supports the primary care team by providing panel management to decrease the number of patients lost to care. Non-compliant in follow up care and disconnected from primary care.
.Assemble information concerning patient's clinical background and referral needs.
.Assist patients in problem solving potential issues related to the health care system,financial or social barriers (e.g.,request interpreters as appropiate intert (e.g., request interpreters as appropriate, transportation services or prescription assistance).
.Ensure that referrals are addressed in a timely manner.
.Performs other duties as assigned
Men's Warehouse, Washington, DC
Customer Service Representative April 2007
Perform customer service activities including selling and suggesting additional related merchandise. Maintain merchandise stocks and department appearance according to company's marketing standards. Demonstrate a thorough knowledge of all aspects of department operation. Resolve problems efficiently and professionally by applying accurate knowledge of measurements and customizations, and product quality assurance. Adhere to company's policy.
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Resume Overview
School Attended
- Roosevelt Stay Senior High School, Washington, DC
Job Titles Held:
- Clinical Operations Representative
- Patient Registration Clerk/Patient Care Coordinator
- Customer Service Representative
Degrees
- High School Diploma
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