Clinical Business Operations Representative 3
Quick Summary
Process PAs for medications, specialty medications, procedures, imaging, and other services within the required timeframe. Review Requests: Make sure each request has the correct insurance,
Keep up with insurance changes, payer requirements, PA criteria, and department processes.
The University of Miami/UHealth department of Neurology has an exciting opportunity for a Full Time Clinical Business Operations Representative 3 to work Remote. The Clinical Business Operations Representative 3 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 3 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: 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.
Maintains confidentiality of all information.
Adheres to University and unit-level policies and procedures and safeguards University assets.
Responsibilities
~1 min readThe Prior Authorization CBOR 3 manages complex authorization requests and appeals, works with insurance plans and clinical teams to resolve issues, helps prevent delays in patient care, and serves as a resource to staff by providing guidance, training, and support with challenging cases.
Requirements
~1 min readHigh 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.
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.
Location & Eligibility
Listing Details
- Posted
- September 18, 2026
- First seen
- October 9, 2026
- Last seen
- October 9, 2026
Posting Health
- Days active
- 0
- Repost count
- 0
- Trust Level
- 13%
- Scored at
- October 9, 2026
Signal breakdown
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