Clinical Business Operations Representative 2 (H)

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The University of Miami Health System, "UHealth", Department of Pediatrics- Gastroenterology has an exciting opportunity for a Full-Time Clinical Business Operations Representative 2 to work in Miami.

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.

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.

• 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.

Department Specific Functions:

• Maintain and monitor the assigned cases in the Department’s Microsoft Teams worklist.

• Ensure timely follow-up and action on all cases to meet departmental goals.

• Serve as the primary point of contact for parents or caregivers, maintaining consistent and professional communication.

• Request and secure insurance authorizations for procedures and radiology examinations.

• Verify medical coverage and obtain necessary medical clearances for patient procedures.

• Schedule patient procedures in Cerner and coordinate with the hospital’s Pediatric Specialized Procedure Unit staff.

• Update and manage the provider’s calendars with confirmed procedure appointments and post-op follow-ups.

• Coordinate new consult appointments for the RD Nutrition clinic as needed.

• Confirm appointments for the RD Nutrition clinic weekly.

• Answer incoming calls, document call details in Epic, and ensure appropriate follow-up by routing messages to the correct staff or provider.

• Make outgoing calls to confirm or schedule appointments, request medical records, and provide updates to families.

• Verify insurance and obtain required authorizations for imaging studies.

• Communicate with families to confirm imaging locations and ensure all details are sent to the appropriate hospital or freestanding facility.

• Assist in managing the reschedule bump list when provider clinics are closed with less than 45 days’ notice.

• Contact and reschedule affected patients under direction from leadership.

• Manage incoming faxes and ensure proper scanning of records into the patient’s chart.

• Forward signature-required requests to the corresponding provider.

• Reach out to secure appointments for new referrals, as necessary.

• Assist with the training and cross-training of new hires to ensure seamless integration into the team.

• Support the department with additional tasks and projects as assigned by leadership to meet organizational needs.

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