Insurance Office Clinical Service Rep II (Revenue Cycle Specialist)

University of Florida•Gainesville, FL

12d•$20 - $22•Onsite

About The Position

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 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.

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.

Nice To Haves

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 skills
Verbal and written communication skills
Math skills
Leadership skills
Customer Service Oriented skills
Ability to concentrate
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 demeanor

Responsibilities

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.