Clinical Business Operations Representative 3

• 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.
• 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.

• Answer incoming calls, manage patient messages through UChart, and respond to inquiries from patients, providers, and internal and external customers. Route clinical concerns requiring assessment to appropriate licensed clinical personnel.

• Coordinate and optimize physician clinical schedules, including appointment availability, cancellations, rescheduling, and unanticipated openings to maximize patient access.

• Serve as a primary point of contact for patient scheduling and coordination across UHealth clinical locations and satellite facilities.

• Collaborate with clinical operations staff, providers, and scheduling teams to ensure efficient patient flow, appointment coordination, and continuity of clinical services.

• Support Rapid Care scheduling workflows, including appointment scheduling, patient confirmations, scheduling adjustments, and timely communication with providers and clinical teams.

• Monitor provider templates and appointment availability, proactively identifying scheduling opportunities and escalating barriers that may impact patient access.

• Coordinate appointments for VIP patients as needed, ensuring timely communication and appropriate follow-up.

• Maintain accurate clinical scheduling records and ensure scheduling information is organized, accessible, and communicated to appropriate stakeholders.

• Receive, review, and coordinate patient-related escalations, ensuring timely communication, appropriate follow-up, and resolution.

• Track outstanding patient escalations, monitor resolution status, and escalate complex or unresolved matters to clinical leadership as appropriate.

• Track outstanding patient escalations, monitor resolution status, and escalate complex or unresolved matters to clinical leadership as appropriate.

• Coordinate the receipt, review, processing, and uploading of external patient medical records into Epic/UChart.

• Facilitate the uploading of patient imaging CDs into the appropriate imaging systems to ensure availability for provider review.

• Verify that medical records, imaging, and supporting documentation are accurately associated with the appropriate patient chart.

• Assist providers and clinical teams with obtaining outside medical records, imaging studies, and additional documentation necessary for patient appointments.

• Monitor and manage incoming and outgoing departmental faxes, ensuring timely review, distribution, and appropriate routing to providers and clinical teams.

• Upload and index faxed documentation into patient medical records and follow up on missing or incomplete information.

• Maintain patient confidentiality and ensure compliance with HIPAA, University policies, and departmental documentation standards.

• Coordinate and support prior authorization requests for medications, diagnostic testing, procedures, and other clinical services to ensure timely patient access to care.

• Verify insurance requirements and determine authorization needs for scheduled services.

• Submit, monitor, and follow up on prior authorization requests with insurance companies and appropriate internal departments.

• Collaborate with providers, clinical staff, and authorization teams to obtain required clinical documentation and resolve authorization-related barriers.

• Monitor pending authorizations, communicate approval or denial status, and escalate delays that may impact patient care or scheduled appointments.

• Assist with coordinating peer-to-peer reviews, appeals, and additional documentation requests as needed.

• Maintain accurate authorization records and documentation in Epic/UChart and other applicable systems.

• Coordinate and maintain daily clinic room assignments to support efficient utilization of clinical space and resources.

• Manage provider room requests, room availability, and scheduling adjustments based on operational needs.

• Maintain and update the clinic room master schedule, ensuring accurate communication of room assignments and changes.

• Collaborate with clinical leadership, providers, and administrative teams to resolve room scheduling conflicts and accommodate changing clinical needs.

• Identify opportunities to improve clinic space utilization, operational workflows, and resource allocation.

• Identify opportunities to improve clinic space utilization, operational workflows, and resource allocation.

• Create, update, and distribute physician on-call calendars, including Stroke coverage for Jackson Memorial Hospital and UHealth Tower, as assigned.

• Maintain communication with hospital and outpatient clinical staff to optimize physician schedules and coordinate clinical activities.

• Communicate regularly with division leadership, providers, and clinical operations staff regarding scheduling changes, patient appointments, and operational needs.

• Assist with procedure and medication authorization workflows, including submission, follow-up, and coordination with appropriate authorization teams.

• Maintain historical scheduling records, operational databases, reports, and documentation to support departmental needs.

• Provide cross-coverage and administrative assistance to other departmental staff as needed to ensure continuity of operations.

• Provide cross-coverage and administrative assistance to other departmental staff as needed to ensure continuity of operations.

• Support departmental initiatives, workflow improvements, and special projects aimed at enhancing operational efficiency and patient access.

• Maintain accurate administrative records, databases, and reports to support departmental operations.

• Perform other related duties as assigned to support the operational and administrative needs of the Department of Neurology.

• High School Diploma or equivalent/relevant experience certification or license
• Minimum 2 years of relevant experience required

• Learning Agility: Ability to learn new procedures, technologies, and protocols, and adapt to changing priorities and work demands.
• Teamwork: Ability to work collaboratively with others and contribute to a team environment.
• Technical Proficiency: Skilled in using office software, technology, and relevant computer applications.
• Communication: Strong and clear written and verbal communication skills for interacting with colleagues and stakeholders.