Clinical Service Representative III

Summary

Serve as a leader to Clinical Service Representative teams and/or specialized clinical teams. Handle patient information; provide specific customer services which may include handling patient phone calls, scheduling appointments, scheduling ancillary tests, assisting with hospital to hospital transfers, accompanying physician to clinic to assist with patient flow, assessing patient information, and/or coordinating clinic visits for patients.

Examples of Work

Job functions are specific duties that would be included in the essential functions of the job description. These functions are not all-inclusive nor do they cover the full extent of the duties performed.

• Shares expertise and acts as team leader; trains and mentors clinical program assistants within service area; instructs co-workers as needed regarding IDX scheduling, HIS reporting, CPT and ICD-10 coding; acts as trainer and information resource for new and existing clinic applications. Represents department on college/department committees; makes recommendations for improvement in internal policies and procedures.
• Communicates directly with MDs, extenders, nurses to assist patient and coordinate care. Expedite patient financial counseling and medical record processing; interacts with other medical specialties and ancillary services to arrange tests and obtain authorization; provides administrative support to providers and assist in organization of clinical service; problem solves issues with registration, schedules, prescription refills, track lab/x-ray results; organizes patient information for timely provider review; performs scheduling duties including bed control and preauthorization; assists in creating content for and preparing new patient packets.
• Answers all incoming calls from patients, physicians and other health care providers (internal and external), attorneys, pharmacies, medical supply, drug companies, etc.; responds to patient, physician and attorney questions directly within scope of position; routes calls to resident, physician extender or physician when appropriate.
• Gathers and/or verifies patient information including demographics, insurance coverage and financial status; obtains authorization for clinical care, procedures and ancillary studies. Enters all scheduling information into IDX system.
• Schedules patient appointments and obtains prior medical records and studies if appropriate; arranges for special needs when applicable: works with other sub-specialties (i.e., Radiology/Pathology) when applicable for patient scheduling.
• Arranges associated clinical, diagnostic or laboratory services and obtains authorizations when necessary; directs patients to appropriate providers for other health care issues; completes and routes direct referrals to other clinical services.
• Greets patients and confirms appointments; inspects insurance cards or authorization notices; identifies and collects deductible, co-payment or deposit on services; explains and satisfies any necessary patient signature requirements.

Education and Experience

High school diploma or equivalent and four years of medical office experience, that includes the knowledge of CPT and ICD-10 coding guidelines as well as basic medical terminology. Appropriate college coursework or vocational/technical training may substitute an equivalent rate for the required experience.

Licensure and Certification

None

Supervision

None

To see common career pathways for each position at the University of Florida please visit the Career Paths section of the UFHR website.