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Clinical Business Operations Representative 2

The University of Miami/UHealth department of Neurology has an exciting opportunity for a Full Time Clinical Business Operations Representative 2 to work at the UHealth Medical Campus. 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.

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.

Process incoming referrals for new and existing patients.

Verify referral accuracy, ensuring all required information is complete.

Communicate with referring providers and patients to address missing or incomplete details.

Obtain prior authorizations from insurance companies for diagnostic tests, procedures, and treatments.

Submit the necessary clinical documentation and forms to insurance providers.

Follow up on authorization requests to ensure timely approval and resolve any denials or delays.

Provide department with updates on their referral and authorization statuses.

Coordinate with neurology providers and clinic staff to schedule appointments upon approval.

Maintain detailed logs of all referrals and authorizations on PA tracker.

Generate weekly or monthly reports to track referral volumes, approval times, and outstanding authorizations.

Ensure compliance with departmental and institutional policies for referral and authorization processes.

Provide excellent customer service to ensure a positive patient experience.

Resolve issues related to referral errors, authorization denials, or delays.

Work with insurance companies to appeal denied authorizations when necessary.

This role requires strong organizational skills, attention to detail, knowledge of medical insurance policies, and the ability to provide excellent service to both patients and clinical staff.

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

High school diploma or equivalent

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.

Skills in collecting, organizing, and analyzing data.

Ability to work independently and/or in a collaborative environment.

Commitment to the University’s core values.

Any relevant education, certifications and/or work experience may be considered.

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.

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.

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