Clinical Business Operations Representative 3

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The department of Medicine has an exciting opportunity for a full-time Clinical Business Operations Representative 3 to work at the UHealth campus. The Clinical Business Operations Representative 3 (H) 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 3 (H) assists patients in a courteous, efficient and professional manner and ensures adherence to divisional and departmental service standards.

CORE JOB FUNCTIONS

• 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. 

Department Specific Functions

• Answer multiple phones lines for the POD: triage incoming calls, responds to questions, directs calls, and documents messages in Epic.
• Manage Prior Authorization (PA) Requests, inbox, and tracking sheet; enter all PA request in CoverMyMeds (CMM)/ work with pharmacy and patient's insurance plan for approval.
• Maintain close contact with pharmacies/ patient insurance to achieve faster PA approval.
• Manage in basket patient calls from UHealth Pharmacy Prior Authorization.
• Confirm patient appointments i.e. obtain medical records/ recent labs/ x-rays/pertinent information; following confirmation guidelines as needed.
• Assist in completing clerical portion of FMLA/ parking permit/long term disability document.
• Check and distributes faxes and emails; upload records in Epic as needed. Route patient prescription refill requests in EPIC to provider for approval, as needed.
• Responsible for UChart In Basket messages: Results notes/ RX Request/ Pt Calls/ Cc Chart and Rx Response assuring all messages are marked for completion on a weekly basis.
• Manage e-consult inbox. Obtain referrals to other specialties i.e., radiology/ kidney MRIs. Coordinate CTU patient appointment requests via CTU email, as needed.
• Reduce call abandonment rate to <5%. Initiate transplant referrals i.e. MTI, Cleveland Clinic, etc. Initiate DaVita new patient starts.
• Coordinate and assist with clinic changes as needed (rescheduling under 45 days; last minute clinic changes) in accordance with DOM & UHealth Rescheduled and Cancelled Clinics Policy - PolicyStat ID 10530754.
• Manage escalation requests. 
• Act as liaison between patient and providers i.e. communicate scripted instructions to patient from provider.
• Act as liaison between patient and off-site testing facilities i.e. Natera.
• Assist in the training and on-boarding on new staff members.
• Other medical/administrative related request(s) as needed.
• Provide coverage for co-workers when assigned or as need arises.
• Other duties as directed by Sr. Practice Manager or Sr. Dept./Division Administrator.

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.