Insurance Office Clinical Service Rep II (Revenue Cycle Specialist)
University of Florida
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Job summary
The University of Florida's Student Health Care Center is seeking two Clinical Service Representative II (Revenue Cycle Specialist) positions on the main campus in Gainesville. You will support the billing and reimbursement process and help students access healthcare services.
Reporting to the Coding and Reimbursement Supervisor, you’ll enter charges, verify eligibility, review patient accounts, and resolve claim denials while providing patient financial counseling.
Qualifications
- High school diploma or equivalent and two years of relevant office experience.
- Appropriate college coursework or vocational/technical training may substitute for the required experience.
Responsibilities
- Support billing and reimbursement processes for professional services.
- Enter charges, verify insurance, obtain authorizations, and counsel patients.
- Post insurance and patient payments; monitor claims and follow up on denials.
- Assist with insurance updates in EPIC and educate staff on the insurance process.
Skills
Education
Tools
Job description
Insurance Office Clinical Service Rep II (Revenue Cycle Specialist)
Job No: 541622
Work Type: Full Time
Location: Main Campus (Gainesville, FL)
Categories: Veteran's Preference Eligible, Health Care Administration/Support
Department: 35010204 - SH-INSURANCE OFFICE
Clin Service Representative II
High school diploma or equivalent and two years of relevant office experience. Appropriate college coursework or vocational/technical training may substitute an equivalent rate for the required experience.
The Opportunity
The Student Health Care Center (SHCC) at the University of Florida is seeking two Clinical Service Representative II (Revenue Cycle Specialist) positions. Reporting to the Coding and Reimbursement Supervisor, you'll play a key role in supporting the billing and reimbursement process while helping students access and understand healthcare services.
The key responsibilities of the position include the following:
Facilitating established financial processes that enable and expedite the billing and collection of professional services. This includes entering charges, applying basic coding/billing rules, maximizing collections, verifying insurance, obtaining authorizations for services, reviewing patient account details, and financial counseling of patients. Accountable for resolving front-end edits, rejections, and information requests to achieve practice goals.
Responsible for reviewing and updating patient account details and entering and verifying insurance. Obtain all consent forms, copies of identification/ insurance cards, and other required documentation. Verify student status/eligibility for services and select the appropriate guarantor for appointment. Ensures scanning of paper documents in EPIC is properly completed, labeled, and placed in the correct tab of the patient EHR. Work effectively with a wide range of students whose needs may be difficult to assess on initial contact.
Responsible for posting insurance and patient payments accurately and efficiently. Monitor claims through the reimbursement process and follow up on outstanding claims. Investigate and resolve claim denials, rejections, and underpayments. Submit appeals and supporting documentation to insurance carriers as needed. Communicate with insurance companies to resolve claim and payment issues. Maintain accurate billing records and documentation. Assist patients with billing questions, payment processing, and balance inquiries. Collaborate with providers and staff to support accurate charge capture and reimbursement
Troubleshooting, researching, and making corrections to ensure claims are clean and reprocessed for payment or written off when not eligible for payment.
Assist with insurance updates in the EPIC system at the beginning of each quarter. Serve as in-house insurance educator for support staff and assist with questions on the insurance process and application in the EPIC system.
- 8 am to 5 pm daily (Monday through Friday) and one-hour lunch during Fall and Spring semesters.
- 8 am to 4:30 pm daily (Monday through Friday) with a one-half hour lunch during Summer semesters.
The Student Health Care Center (SHCC) at the University of Florida is seeking two Clinical Service Representative II (Revenue Cycle Specialist) positions. Reporting to the Coding and Reimbursement Supervisor, you'll play a key role in supporting the billing and reimbursement process while helping students access and understand healthcare services.
The key responsibilities of the position include the following:
Facilitating established financial processes that enable and expedite the billing and collection of professional services. This includes entering charges, applying basic coding/billing rules, maximizing collections, verifying insurance, obtaining authorizations for services, reviewing patient account details, and financial counseling of patients. Accountable for resolving front-end edits, rejections, and information requests to achieve practice goals.
Responsible for reviewing and updating patient account details and entering and verifying insurance. Obtain all consent forms, copies of identification/ insurance cards, and other required documentation. Verify student status/eligibility for services and select the appropriate guarantor for appointment. Ensures scanning of paper documents in EPIC is properly completed, labeled, and placed in the correct tab of the patient EHR. Work effectively with a wide range of students whose needs may be difficult to assess on initial contact.
Responsible for posting insurance and patient payments accurately and efficiently. Monitor claims through the reimbursement process and follow up on outstanding claims. Investigate and resolve claim denials, rejections, and underpayments. Submit appeals and supporting documentation to insurance carriers as needed. Communicate with insurance companies to resolve claim and payment issues. Maintain accurate billing records and documentation. Assist patients with billing questions, payment processing, and balance inquiries. Collaborate with providers and staff to support accurate charge capture and reimbursement
Troubleshooting, researching, and making corrections to ensure claims are clean and reprocessed for payment or written off when not eligible for payment.
Assist with insurance updates in the EPIC system at the beginning of each quarter. Serve as in-house insurance educator for support staff and assist with questions on the insurance process and application in the EPIC system.
The mission of the SHCC is to help every student achieve optimal health in pursuing personal and academic success.
Our vision is to be the preferred healthcare provider for University of Florida students as a nationally recognized leader in the collegiate health specialty.
The SHCC is fully accredited by the AAAHC and is located in a state-of-the-art WELL-certified building on UF's campus. Medical services offered at the SHCC include primary care, sports medicine, urgent care, gynecology, psychiatry, allergy/immunization clinic, and travel medicine. Radiology, pharmacy, lab, and physical therapy are also on site.
Learn more about SHCC here https://shcc.ufl.edu/
UF is one of the nation's top universities and a dynamic and rewarding place to work. UF is in Gainesville, one of Florida's most livable cities. Known for its natural attractions (wetlands, forests, springs, wildlife) and cultural offerings (music, theater, visual arts, and historic districts), the area also is gaining a reputation as a thriving hub for high-tech start-ups, as well as invention and research collaborations. We are excited about what's happening here and know you will want to be a part of it.
The Guide to Greater Gainesville shares all that you need to learn about the Heart of Florida, including neighborhood and city information, schools and zoning, culture and leisure, sports and fitness, healthcare and much more. Learn more at https://guidetogreatergainesville.com/
$20.00-$22.00 per hour
Enjoy stability andsupportwith UF's unique range of benefits and opportunities. With a robust healthcare package, generous leave policies, retirement planning, and professional development, you can achieve a healthy work-life balance, plan for your future, and advance your career.
Full-time TEAMS employees will accrue vacation leave at a rate of 6.769 hours biweekly/22 days annually and sick leave at a rate of 4 hours biweekly/13 days annually. In addition, employees are eligible for ten paid holidays each year.
High school diploma or equivalent and two years of relevant office experience. Appropriate college coursework or vocational/technical training may substitute an equivalent rate for the required experience.
- Experience with computer programs for word processing and various computer software applications
- Experience with computer-generated appointment systems and EHR
- Understanding of insurance plans, terms
- Ability to interpret Explanation of Benefits
- EPIC system knowledge and experience
- Understanding of Bursar file systems
- Knowledge of CPT, HCPCS, and ICD-10
- Working knowledge of WayStar and Availity
- Organizational
- Verbal and written communication
- Math
- Leadership
- Customer Service Oriented
- Concentration
- Ability to work independently
- Ability to organize and maintain patient records
- Ability to plan, organize, and coordinate work assignments
- Ability to communicate effectively, both verbally and in writing
- Ability to evaluate problems and implement solutions
- Ability to compile and analyze data for administrative decisions
- Work independently using good judgment in establishing and maintaining office procedures and routines
- Friendly
- Ability to work independently
- Ability to organize and maintain patient records
- Ability to plan, organize, and coordinate work assignments
- Ability to communicate effectively, both verbally and in writing
- Ability to evaluate problems and implement solutions
- Ability to compile and analyze data for administrative decisions
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