Clinical Business Operations Representative 2 (H)
University of Miami

Job Info

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Current Employees:

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The department of Surgery has an exciting opportunity for a Clinical Business Operations Representative 2 position. The incumbent 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 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: 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.
  

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.

CORE QUALIFICATIONS

Education:

High school diploma or equivalent

Certification and Licensing:

Not Applicable

Experience:

Minimum 1 year of relevant experience

Knowledge, Skills, and Attitudes:

• 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.
  

DEPARTMENT ADDENDUM

Department Specific Functions

1 year Epic experience which includes the following: new patient registration, making and rescheduling appointments, able to identify where to look for patient lab results, imaging, and physician's encounter. In addition to that updating demographics including when patient have new insurance policy. 3 or more years of insurance verification using system like Availity and insurance portal 3 or more years of surgical coordination and how to submit to insurance for surgical approval 3 years of working in a surgical specialty office Assist the patients from the being to the process of the surgery till the end of all post-op visits with surgeon, arnp, and dietitian Patient advocates need 3 years of medical terminology Communicate effectively with different departments within our organization verbally and via email. Send email communications and reply in a timely manner. Provide excellent customer service delivery while maintaining favorable impressions on patients. Verify insurance benefits for all patients within 48 hours of registration. Call patients to communicate benefits verification and to schedule appointments. Input patient data such as demographics, insurance, and appointment information in Exemplo. Explain program services and options to patients clearly and effectively. Act as a contact person for all non-clinical patient questions and concerns. Report pipeline status to Program Manager on a weekly basis and to surgeon on a monthly basis. Counsel patients with exclusions on self-pay and financing options. Track patient status and all insurance and clinical requirements in tracking tool. Develop expertise on requirements for authorization for each insurance company with which the program works, including diet history, medical history and psychological evaluation requirements. Assist patients with insurance appeals if surgery authorizations are denied. Always maintain professional demeanor with patients, providers and staff. Maintain patient confidentiality. Photocopying and faxing documents as needed. Prepare and modify documents including correspondence, drafts, memos and emails.

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The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.

UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for.

Patient safety is a top priority. As a result, during the Influenza ("the flu") season (September through April), the University Of Miami Miller School Of Medicine requires all employees who provide ongoing services to patients, work in a location (all Hospitals and clinics) where patient care is provided, or work in patient care or clinical care areas, to have an annual influenza vaccination. Failure to meet this requirement will result in rescinding or termination of employment.

The University of Miami is an Equal Opportunity Employer - Females/Minorities/Protected Veterans/Individuals with Disabilities are encouraged to apply. Applicants and employees are protected from discrimination based on certain categories protected by Federal law. Click here for additional information.

Job Status:
Full time

Employee Type:
Staff

Pay Grade:
H4

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