Access Call Center Representative

Kids Are Our Everything

Schedule, pre-certify, verify and document procedures for ancillary services and minor surgical treatments. Serve as a liaison between call center, clinics, and external providers. Provide accurate documentation following all established protocols to register and schedule patients' appointments by telephone. Ensure that appointments are scheduled in accordance within departmental guidelines. Responsible for obtaining and validating patient information from various sources and to ensure information entered into the computer management system is accurate. Perform responsibilities within established customer service standards. Provide assistance to other employees within their department as well as other departments.

Minimum Education High School Diploma or GED (Required)Associate's Degree (Preferred)Minimum Work Experience 3 years Experience performing patient registration and scheduling, medical insurance screening and verification (Required)Required Skills/Knowledge Excellent customer service skillsDemonstrated problem solving and critical thinking skillsComputer knowledge necessaryMicrosoft Office experience requiredMust complete Patient Access training curriculum and pass all competency assessments, including the ability to type minimum of 30 words per minuteKnowledge of medical terminology and CPT-4/ICD-10 coding required Functional Accountabilities Registration and Scheduling Services

• Ensure accuracy of scheduling patients using the applicable scheduling system for the department: schedule routine and add-on exams; schedule complex radiological exams prior to the patient's arrival.
• Review patient Surgical Plan of Care from Physician when scheduled in conjunction with diagnostic exams. Schedule complex ancillary and non-complex surgical procedures using scheduling system; while coordinating with both the physician's and parent's schedules
• 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
• Counsel parents or refers parent to Financial Information Center (FIC) for establishing payment schedule or method of payment.
• Responsible for information distributed via email; check work email a minimum of 3 times daily and respond to inquiries within 24 hours (or next business day)

Verifying Insurance/ Authorization

• Verify insurance eligibility using applicable eligibility system. Ensure that managed care carve outs (ie: lab and radiology) are adhered to. Notify insurance companies or review agency as required by hospital contract and document notification as defined by policy.
• Obtain authorizations as needed with clinical information; document authorization in the patient account accordingly.
• Notify parents of the need for completed insurance referral form or pre-authorization prior to scheduled/unscheduled appointment.

Performance Improvement, Mentoring, and Training

• Monitor and correct registration errors on a daily basis ensuring quality standards.
• Provide input to manager about registration errors for ongoing training purposes.
• Work with manager to reduce registration and authorization denials.
• Provide expertise to peers throughout the institution: collaborate with peers to ensure exams are scheduled appropriately.

Productivity and Quality

• Complete calls in an accurate and timely manner; transfer calls to appropriate areas as needed; notify manager/supervisor of difficult calls (clarification re insurance, problem callers, etc.); seek appropriate resources to solve problems effectively.
• Respond to patient portal work lists (i.e. appointment requests, fax queues, email requests, etc.).
• Maintain high ACD Quality departmental standards including but not limited to scripting, abandonment rate, call to answer, availability.
• Anticipate customer service needs to "prevent fires".

Program Knowledge

• Stay current on insurance company updates and changes provided by the Financial Clearance Center.
• Understand Call Center functions, staffing and processing; complete all required fields of information in the appropriate system.
• Learn and maintain working knowledge of current and new systems.

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.

Children's National Medical Center