Insurance Office Clinical Service Rep II (Revenue Cycle Specialist)

Classification Title:

Clin Service Representative II

Classification Minimum Requirements:

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.

Job Description:

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:

Financial Support

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.

EHR Support

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

Denied Claims

Troubleshooting, researching, and making corrections to ensure claims are clean and reprocessed for payment or written off when not eligible for payment.

Payment posting

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.

Typical Schedule:

• 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 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:

Financial Support
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.

EHR Support
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

Denied Claims
Troubleshooting, researching, and making corrections to ensure claims are clean and reprocessed for payment or written off when not eligible for payment.

Payment posting
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.

Typical Schedule:
• 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.

About the Student Health Care Center (SHCC)

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

About the University of Florida

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 City of Gainesville

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

Expected Salary:

$20.00-$22.00 per hour

Exclusive Perks and Benefits

Enjoy stability and support with UF’s unique range of benefits and opportunities. With a robust healthcarepackage, generous leavepolicies, retirementplanning, and professional development, you can achieve a healthy work-lifebalance, 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.

Required Qualifications:

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.

Preferred:

EXPERIENCE:

• Experience with computer programs for word processing and various computer software applications
• Experience with computer-generated appointment systems and EHR

KNOWLEDGE:

• 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

SKILLS:

• Organizational
• Verbal and written communication 
• Math
• Leadership
• Customer Service Oriented

ABILITIES:

• 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

OTHER QUALIFICATIONS:

• 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

Special Instructions to Applicants:

In order to be considered, you must upload your cover letter, resume, and a list of at least 3 references.

Applications must be submitted by 11:55 p.m. (ET) of the posting end date.

This position is eligible for Veteran’s preference. If you are claiming Veteran’s preference, please upload a copy of your DD 214 Member Copy 4 with your application for consideration. See our Veteran's Preference Pagefor more specific information.

Health Assessment Required:No