Clinical Business Operations Representative 3

University of Miami•Miami, FL

1d•Onsite

About The Position

The University of Miami/UHealth Department of Neurology is hiring a full-time Clinical Business Operations Representative 3 in Miami, Florida. The role facilitates prompt resolution of pre- and post-care issues arising in daily clinical operations and performs administrative and receptionist duties, including answering calls, managing patients, and obtaining necessary patient care information and records. The representative assists patients courteously and professionally while meeting divisional and departmental service standards. The position supports patient access and scheduling, patient escalations, medical records and imaging workflows, fax management, prior authorizations and insurance coordination, clinic room management, provider scheduling, and general departmental operations. The representative works with patients, providers, clinical teams, leadership, and administrative staff to coordinate appointments and care-related information, maintain accurate records, support efficient clinic operations, and contribute to process improvements. The role requires maintaining patient confidentiality and following HIPAA and University and departmental policies.

Requirements

High school diploma or equivalent, or relevant experience, certification, or license.
At least 2 years of relevant experience.
Ability to learn new procedures, technologies, and protocols and adapt to changing priorities and work demands.
Ability to collaborate with others and contribute to a team environment.
Proficiency with office software, technology, and relevant computer applications.
Strong written and verbal communication skills.

Responsibilities

Manage expectations related to pre- and post-patient care and obtain or review patient demographic, insurance, referral, and clinical record information for completeness.
Answer and triage incoming calls, respond to inquiries, direct callers, document messages in appropriate software, and greet and direct visitors.
Work collaboratively with employees to resolve problems, support smooth practice operations, and provide co-worker coverage when assigned or needed.
Communicate regularly with physicians, managers, peers, trainees, staff, patients, providers, and internal and external customers.
Manage patient messages through UChart and route clinical concerns requiring assessment to licensed clinical personnel.
Coordinate and optimize physician schedules, appointment availability, cancellations, rescheduling, unanticipated openings, Rapid Care scheduling, and VIP patient appointments as needed.
Serve as a contact for patient scheduling across UHealth clinical locations and satellite facilities, and collaborate with clinical operations and scheduling teams to support patient flow and continuity of services.
Monitor provider templates and appointment availability, identify scheduling opportunities, and escalate barriers affecting patient access.
Receive and coordinate patient-related escalations, track resolution status, follow up, and escalate complex or unresolved matters to clinical leadership as appropriate.
Receive, review, process, and upload external medical records into Epic/UChart; facilitate uploading imaging CDs; and ensure documents are associated with the correct patient chart.
Assist providers and clinical teams in obtaining outside medical records, imaging, and other appointment-related documentation.
Manage incoming and outgoing departmental faxes, route them appropriately, upload and index faxed documentation in patient records, and follow up on missing or incomplete information.
Coordinate prior authorizations for medications, diagnostic testing, procedures, and other clinical services; verify insurance requirements; submit and monitor requests; and communicate approval or denial status.
Collaborate with providers, clinical staff, and authorization teams to obtain documentation, resolve authorization barriers, coordinate peer-to-peer reviews and appeals, and escalate delays that may affect care.
Maintain accurate authorization records in Epic/UChart and other applicable systems while protecting patient confidentiality and complying with HIPAA and documentation standards.
Coordinate daily clinic room assignments, provider room requests, room availability, and scheduling adjustments; maintain the clinic room master schedule and help resolve conflicts and improve space utilization.
Create, update, and distribute physician on-call calendars, including Stroke coverage for Jackson Memorial Hospital and UHealth Tower, as assigned.
Communicate with hospital and outpatient clinical staff and departmental leadership about physician schedules, patient appointments, and operational needs.
Maintain historical scheduling records, operational databases, administrative records, reports, and documentation.
Support departmental initiatives, workflow improvements, and special projects; perform other related duties as assigned; and follow University and unit-level policies and procedures while safeguarding University assets.