Clinical Business Operations Representative 1

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The University of Miami/UHealth Department of Orthopedics has an exciting opportunity for a full time Clinical Business Operations Representative 1 to work in Miami, FL. The Clinical Business Operations Representative 1 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 1 assists patients in a courteous, efficient and professional manner and ensures adherence to divisional and departmental service standards.

CORE JOB FUNCTIONS

1. Assists the department in managing expectations surrounding pre and post patient care.

2. Obtains or reviews all patient demographic information, insurance information and referral numbers. 3. Reviews clinical records for completeness including authorization, signatures, missing data and other patient information.

4. Answers multiple telephones for the department: triage incoming calls, responds to questions, directs calls, and documents messages in the appropriate software.

5. Greets visitors and callers, handles their inquiries, and directs them to the appropriate employee according to their needs.

6. Works cooperatively with fellow employees to solve problems and enhance the smooth and efficient flow of the practice.

7. Provides coverage for responsibilities of co-workers when assigned or as need arises.

8. Develops and promotes the use of effective methods of communicating with physicians, managers, peers, trainees, and staff on a regular basis.

9. Maintains confidentiality of all information.

10. 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
High School Diploma or equivalent/relevant experience, certification or license
No previous experience required

Knowledge, Skills and Abilities:

• 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.

This is a core job profile description and is not reflective of all duties that may be assigned to a specific position in each individual department. The above statements are intended to describe the general nature and primary responsibilities of this core job profile. Specific duties and tasks may vary based upon departmental needs. Other duties may be assigned to the above consistent with the knowledge, skills, and abilities required for the job.

Department Specific Functions:

Supports Coordination of Pre- and Post-Operative Orthopaedic Care:
Assists in managing expectations and logistics related to patient care before and after orthopaedic procedures, ensuring alignment with surgical protocols, rehabilitation plans, and follow-up schedules.

Manages Patient Intake for Orthopaedic Services:
Accurately obtains and verifies patient demographic data, insurance details, and referral/authorization information specific to orthopaedic services and procedures.

Ensures Completeness of Orthopaedic Clinical Documentation:
Reviews orthopaedic clinical records for accuracy and completeness, including pre-surgical authorizations, provider signatures, operative reports, and other relevant clinical documentation.

Handles High-Volume, Multi-Line Orthopaedic Scheduling and Triage:
Answers multiple phone lines for the orthopaedics department, triages patient and provider calls regarding appointments, imaging, surgical scheduling, and post-operative concerns, and documents communication in the appropriate systems (e.g., Epic).

Collaborative Workflow with Orthopaedic Team Members:
Works closely with surgeons, advanced practice providers, medical assistants, radiology technicians, and schedulers to ensure smooth clinic and surgical workflows.

Cross-Coverage of Orthopaedic Administrative Roles:
Provides coverage for team members handling orthopaedic scheduling, pre-authorizations, and clinic coordination as needed during absences or high-volume periods.

Facilitates Effective Communication Within the Orthopaedic Team:
Promotes efficient communication among orthopaedic surgeons, practice managers, trainees, residents, and support staff to ensure alignment on clinical and administrative priorities.

Protects Patient Privacy in Compliance with Orthopaedic Standards:
Maintains strict confidentiality of patient health information, including imaging and surgical data, in accordance with HIPAA and departmental guidelines.

Follows Institutional and Orthopaedic Department Policies:
Adheres to all University policies and orthopaedic-specific procedures, ensuring proper use of resources and compliance with clinical, operational, and financial standards.

Assists with coordination of orthopaedic surgical care overload by managing provider schedules, obtaining authorizations, scheduling surgeries and post-operative appointments, and ensuring accurate documentation and timely communication with patients and surgical teams.

Serves as a key administrative liaison for patients and staff by answering high-volume calls, assisting with clinic workflows, verifying insurance and referrals, and collaborating with providers and departments to maintain efficient pre- and post-operative care.

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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.

The University of Miami is an Equal Opportunity Employer. Applicants and employees are protected from discrimination based on certain categories protected by Federal law.

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