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The University of Miami Health System, "UHealth", Department of Pediatrics-Infectious Diseases 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

Validates parking for HIV patients. Collaborates with the Pediatric Coordinator to ensure monthly reports are submitted and parking validations are replenished.

Attends weekly Children’s Medical Services interdisciplinary care coordination meetings with accurate pre-visit insurance verification reporting

Alerts the clinical team immediately regarding special insurance issues, such as Ryan White enrollment due dates, that may affect patient care and laboratory specifications

Financially clears Ryan White sponsored patients in UChart when confirmed

Schedules appointments per individual provider specifications

Notifies staff immediately for patients who present with untoward symptoms such as excessive coughing, complaints of fever, rash, etc.

Assist with clinic flow by monitoring/assisting the nursing staff with patient visit needs

Participates in learning modules designed to achieve Joint Commission Accreditation standards.

Caring for perinatally exposed/infected HIV patients specializing in their considering their sensitive and complex social needs

Required to stay current with the multiple insurance plans encountered, providing advocacy for the patients and preventing visit cancellations

Required to work confidentially with Ryan White patients, making frequent community-based case management contacts, and will alert the team to ensure uninterrupted eligibility for HIV specific services.

Will develop and maintain an SPSS data program to enter survey responses from CMS patients regarding satisfaction surveys; PDSA outcomes will also be included in this data base for future analysis and reporting to the CMS SNAQ team

Will participate in biannual Quality Improvement projects developed by the interdisciplinary team

Assist the Project Coordinator with the collection of patient data relevant to CQI projects as required by the project funding source, Health & Rehabilitative Services Administration (HRSA)

Serve as the primary contact to collaborate with the Divisions’ providers regarding maintaining their availability for scheduling patient care, and will monitor their personal leave requests (PLR) for accuracy

Communicate with other staff about the changes to the provider schedules as they occur. Remain alert to reschedule patients to accommodate PLRs on a continual basis

Tracking of no-shows for the RW patients and alert team of patients consistently missing appointments to address barriers.

Act as the Division’s primary contact for UM’s Patient Access services and the Central Insurance Verification office to ensure patient visits are cleared expeditiously

Maintain accountability for the Division’s non-HIV affected patients ensuring each family referred is individually contacted, with special attention to securing records needed for complex medical cases

Act as liaison between this office and the primary care provider to facilitate services, including but not limited to securing the appropriate referrals, and coordinating return of specialty visit records to the PCP

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, 3years experience in a medical billing, medical office, or hospital setting preferred.

Excellent communication, written and oral skills required.

Knowledge of medical terminology preferred.

Able to handle multiple tasks simultaneously.

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.

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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