Clinical Business Operations Representative 3

University of Miami•Miami, FL

2d•Onsite

About The Position

The University of Miami/UHealth Department of Psychiatry has an exciting opportunity for a full time Clinical Business Operations Representative 3 to work in Miami, FL. This role involves assisting the department in managing expectations surrounding pre- and post-patient care, including obtaining and reviewing patient demographic and insurance information, and ensuring clinical records are complete. The representative will handle multiple telephone lines, triage calls, respond to inquiries, and direct calls appropriately. Key responsibilities also include greeting visitors, collaborating with co-workers to enhance practice efficiency, and providing coverage for colleagues as needed. The position requires developing effective communication methods with various stakeholders and maintaining strict confidentiality of all information while adhering to University policies. Department-specific functions include assisting a Clinical Business Operations Specialist, managing NO-SHOW letters and missed appointment disputes, serving as a primary contact for SharePoint Online communications regarding clinic closures, and managing escalated appointment requests. The role also involves overseeing provider schedules to maintain high fill and schedule rates, managing CRM Work queue escalations, maintaining a high call response rate, providing clinical support to providers, completing weekly clinical preparation, scheduling patient appointments, initiating prior prescription authorizations, and ensuring timely preparation and distribution of provider clinical letters. Additionally, the representative will respond to emails from Shared Services, manage Epic In-Basket messages, upload documents, create and manage referrals through Epic, and assist with daily e-faxes and mail correspondence. Adherence to administrative clinical workflow schedules and attendance policies is also required.

Requirements

High School Diploma or equivalent/relevant experience, certification or license
Minimum 2 years of relevant experience required
Learning Agility: Ability to learn new procedures, technologies, and protocols, and adapt to changing priorities and work demands.
Teamwork: Ability to work collaboratively with others and contribute to a team environment.
Technical Proficiency: Skilled in using office software, technology, and relevant computer applications.
Communication: Strong and clear written and verbal communication skills for interacting with colleagues and stakeholders.
Any relevant education, certifications and/or work experience may be considered.

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: triages 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.
Assist Clinical Business Operations Specialist with assigned clinical tasks during management coverage periods.
Review and manage all NO-SHOW letters and missed appointment disputes.
Serve as the primary point of contact for SharePoint Online communications related to provider clinic closures and patient rescheduling.
Manage escalated appointment requests, including follow-up for UMMD Total Care–insured patients.
Oversee provider schedules to ensure Fill and Schedule rate metrics are maintained at 95-100% capacity.
Oversee CRM Work queue Message Escalations.
Demonstrate the ability to work both independently and collaboratively with coworkers to achieve team and organizational goals.
Maintain a call response rate of 90% or higher for all inbound telecommunications routed through NICE InContact.
Provide clinical support to departmental providers as needed.
Complete weekly clinical preparation for outpatient clinics and provide timely notification to providers.
Schedule patient appointments accurately and efficiently in accordance with departmental guidelines.
Initiate and manage prior prescription authorizations.
Ensure provider clinical letters are accurately prepared, reviewed, and distributed within established timeframes.
Respond to emails from Shared Services departments in a timely and effective manner.
Review Epic In-Basket messages and respond within 24–48 hours.
Upload documents and create, attach, and manage referrals through Epic.
Assist with the daily distribution of e-faxes and departmental mail correspondence.
Adhere to administrative clinical workflow schedules and attendance policies.
Maintain strict confidentiality of all patient and departmental information.