Clinical Business Operations Representative 2- Osher Center for Integrative Medicine

University of Miami•Miami, FL

1d•Onsite

About The Position

The Clinical Business Operations Representative 2 facilitates the prompt resolution of problems related to pre and post care that arise in daily clinical operations. The incumbent performs general administrative and receptionist functions, to include answering incoming calls, efficient management of patients, and the acquisition of necessary patient care and records. The Clinical Business Operations Representative 2 assists patients in a courteous, efficient and professional manner and ensures adherence to divisional and departmental service standards.

Requirements

High school diploma or equivalent
Minimum 1 year of relevant experience
Skill in data entry with minimal errors.
Ability to communicate effectively in both oral and written form.
Ability to work evenings, nights, and weekends as necessary.
Skill in collecting, organizing, and analyzing data.
Ability to work independently and/or in a collaborative environment.
Commitment to the University’s core values.

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.
Greets visitors and callers, handles their inquiries, and directs them to the appropriate employee according to their needs.
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.
Process and manage incoming and outgoing referrals for integrative medicine services.
Obtain and track insurance authorizations, pre-certifications, and referral approvals.
Verify eligibility, benefits, referral requirements, and authorization status prior to scheduled appointments.
Coordinate with referring providers, insurance carriers, and external healthcare organizations to ensure timely patient access to services.
Review patient records for completeness and obtain required documentation before consultations.
Request, receive, and manage outside medical records, imaging, laboratory results, and supporting clinical documentation.
Maintain accurate patient information, referrals, authorizations, and documentation within Epic.
Support providers by managing assigned work queues, patient communications, and administrative follow-up activities.
Coordinate follow-up appointments, diagnostic testing, and ancillary services as directed by providers.
Communicate with patients regarding referrals, authorization status, appointment readiness, and required pre-visit information.
Assist with insurance-related inquiries, denied services, and documentation requests to support revenue cycle processes.
Monitor referral conversion, authorization turnaround times, and other patient access metrics to identify barriers to care.
Support quality improvement initiatives and operational projects aimed at improving access, efficiency, and patient experience.
Assist with departmental reporting, data collection, and performance metrics.
Maintains compliance with HIPAA and organizational policies regarding patient confidentiality and documentation.
Provides backup coverage for Senior Clinic Assistant responsibilities as operational needs require.