Clinical Business Operations Representative 2- Osher Center for Integrative Medicine

• Clinical Business Operations Representative 2
• The University of Miami/UHealth Department of Family Medicine and Community Health has an exciting opportunity for a Full Time, Clinical Business Operations Representative 2 to work in Miami
• 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.
• Process and manage incoming and outgoing referrals for integrative medicine services.
• Obtain and track insurance authorizations, pre-certifications, and referral approvals.
• Verify eligibility, benefits, referral requirements, and authorization status prior to scheduled appointments.
• Coordinate with referring providers, insurance carriers, and external healthcare organizations to ensure timely patient access to services.
• Review patient records for completeness and obtain required documentation before consultations.
• Request, receive, and manage outside medical records, imaging, laboratory results, and supporting clinical documentation.
• Maintain accurate patient information, referrals, authorizations, and documentation within Epic.
• Support providers by managing assigned work queues, patient communications, and administrative follow-up activities.
• Coordinate follow-up appointments, diagnostic testing, and ancillary services as directed by providers.
• Communicate with patients regarding referrals, authorization status, appointment readiness, and required pre-visit information.
• Assist with insurance-related inquiries, denied services, and documentation requests to support revenue cycle processes.
• Monitor referral conversion, authorization turnaround times, and other patient access metrics to identify barriers to care.

None flagged.