Clinical Business Operations Representative 1 (H)

umiami; Miami (FL); On-site; USD 36,000 - 48,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Tuition remission

Job summary

University of Miami/UHealth Department of Medicine seeks a Full Time Clinical Business Operations Representative 1 to support daily clinical operations on the UHealth Campus. The role focuses on resolving patient-care issues, handling administrative tasks, and ensuring precise data entry for demographics, insurance, and referrals.

Responsibilities include triaging calls, scheduling at JMH clinics, coordinating imaging and prior authorizations, and maintaining confidentiality in line with

Qualifications

• High school diploma or equivalent.
• Previous experience not required.
• Bilingual (English/Spanish) highly preferred.
• Previous customer service experience preferred.
• Knowledge, Skills and Attitudes: data entry, communication, data analysis, independent work, confidentiality.

Responsibilities

• Assist in managing expectations around pre and post patient care.
• Obtain or review patient demographic and insurance information.
• Review clinical records for completeness and accuracy.
• Answer incoming calls and document messages in the system.
• Schedule patient appointments and use Cerner EMR to check information.
• Coordinate with home health and pharmacies for documentation and results.
• Assist in scheduling imaging and prior authorizations for medications.
• Greet visitors and direct inquiries to the appropriate staff.
• Maintain accurate clinical records per hospital policy.

Skills

Data entry

Communication skills

Data analysis

Independent worker

Team collaboration

Education

High school diploma or equivalent

Tools

Cerner EMR

Job description

Current Employees:

The University of Miami/UHealth Department of Medicine has an exciting opportunity for a Full Time Clinical Business Operations Representative 1 to work in the UHealth Campus.

Core Summary

The Clinical Business Operations Representative facilitates the prompt resolution of problems related to pre and post care that arise in daily clinical operations. The incumbent in this position performs general administrative and receptionist functions, to include answering incoming calls, necessary for the complete and efficient management of patients, including the acquisition of necessary patient-care and records.

Core Responsibilities

• Assists the department in managing expectations surrounding pre and post patient care.
• Obtains or reviews all patient demographic information, insurance information and referral numbers.
• Reviews clinical records for completeness including authorization, signatures, missing data and other patient information.
• Answers multiple telephones for the department: triage incoming calls, responds to questions, directs calls, and documents messages in the appropriate software.
• Schedule patient appointments at JMH clinics. Skill in using Cerner electronic medical records to check patient information.
• Interacts with home health companies and pharmacies to assist in obtaining results and providing requested documentation.
• Assists in scheduling imaging appointments at JMH facilities. Assists in prior authorization paperwork for specialty medications.
• Greets visitors and callers, handles their inquiries, and directs them to the appropriate persons according to their needs.
• Follows patient appointment guidelines pertaining to overbooking. Schedule appointments (i.e. follow-ups, financial assessment, and labs) in timely manner.
• Call in refills for patients on behalf of doctor(s) when asked to do so. Call patients on a daily basis to remind them about their next day appointment. Call no shows to inquire as to the reason why they did not make the appointment and to make sure they are rescheduled. Cancel and reschedule appointments based on patient and/or doctors request.
• Adjust clinics for doctors on vacations or days off. Contact patients as directed by the physician/providers when necessary.
• Prepare doctors clinic census at least 2 business days in advance for assigned physicians. Send labs and appointment dates to case managers as requested. Obtains consent for Medical Records Information upon other facilities request for medical records.
• Notify medical providers via email and phone of urgent patient matters and follow up promptly.
• Maintains an accurate clinical record, recording information per hospital policy.
• Responsible for obtaining lab and X-ray reports and notifying doctors of results.
• Works cooperatively with fellow employees to solve problems and enhance the smooth and efficient flow of the practice.
• Provides coverage for responsibilities of co-workers when assigned or as need arises.
• Develops and promotes the use of effective methods of communicating with physicians, managers, peers, trainees, and staff on a regular basis. Maintains confidentiality of all information.
• Adheres to University and unit-level policies and procedures and safeguards University assets.

This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary.

Core Qualifications

High school diploma or equivalent

Previous experience not required

Bilingual (English/Spanish) highly preferred.

Previous customer service experience preferred

Knowledge, Skills and Attitudes:

• Skill in data entry with minimal errors.
• Ability to communicate effectively in both oral and written form.
• Skill in collecting, organizing and analyzing data.
• Ability to work independently and/or in a collaborative environment.
• Commitment to the University’s core values.

Any relevant education, certifications and/or work experience may be considered

The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.

UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for.

The University of Miami is an Equal Opportunity Employer. Applicants and employees are protected from discrimination based on certain categories protected by Federal law.

Job Status:

Full time

Employee Type:

Staff