Job Description

Classification Title:

Clin Svc Representative II

Job Description:

The University of Florida's Student Health Care Center (SHCC), within the Department of Community Health and Family Medicine (CHFM), is seeking a Clinical Services Representative II to join our dynamic team. This position plays a critical role in managing denied insurance claims, reconciling patient accounts in the EPIC system with the UF Bursar, and providing excellent service to our diverse student population. The Clinical Services Representative II will support financial and insurance operations, ensure accuracy in patient records, and offer compassionate assistance to students navigating healthcare and billing processes. This position also serves as a leader in the Insurance Department, providing guidance and education to staff while maintaining efficient workflows.

Key Responsibilities

Financial Support

• Facilitate billing and collection of professional services by entering charges, applying coding/billing rules, and maximizing collections.
• Verify insurance coverage and obtain necessary authorizations for services.
• Review patient accounts and provide financial counseling to ensure transparency and patient satisfaction.
• Resolve front-end edits, rejections, and information requests to meet practice goals.

EHR Support

• Review and update patient account details in the EPIC system, ensuring accuracy in patient records.
• Obtain and verify required documentation, including insurance information, consent forms, and identification.
• Confirm student eligibility for services and assign the correct guarantor for appointments.
• Accurately scan and label paper documents within the patient electronic health record (EHR).
• Work effectively with a diverse student population, addressing varied and complex healthcare needs.

Denied Claims Management

• Research and troubleshoot denied claims, making necessary corrections to ensure clean claims for reprocessing or appropriate write-offs.

Insurance Department Leadership

• Serve as the lead in the Insurance Department, verifying insurance and setting up new patient accounts in EPIC.
• Assist with quarterly insurance updates in EPIC to maintain accurate system records.
• Act as an in-house insurance educator, providing guidance to staff on insurance processes and EPIC applications.

General and Miscellaneous Duties

• Provide backup coverage for the clinic’s Operator as needed.
• Assist with other duties and projects as assigned to support clinic operations and patient care initiatives.
• Clinic Hours and Schedule Information: The SHCC operates from 8:00 a.m. to 5:00 p.m. Monday through Friday, with additional Sunday clinic hours during the fall and spring semesters.

Expected Salary:

The salary range is between $18.50 to $19.35 per hour.

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.

Preferred Qualifications:

• Experience with word processing and various computer software applications
• Experience with computer-generated appointment systems and electronic health records (EHR)
• Understanding of insurance plans and terminology
• Ability to interpret Explanation of Benefits (EOBs)
• Experience with EPIC system
• Understanding of Bursar file systems
• Knowledge of CPT, HCPCS, and ICD-10 codes
• Familiarity with WayStar and Availity platforms
• Strong organizational skills
• Excellent verbal and written communication skills
• Proficiency in math for financial tasks
• Leadership capabilities
• Customer service-oriented approach
• Ability to concentrate and work independently
• Ability to organize and maintain patient records
• Skilled in planning, organizing, and coordinating work assignments
• Problem-solving abilities with the capacity to evaluate issues and implement solutions
• Competency in compiling and analyzing data for administrative decision-making
• Ability to use sound judgment in establishing and maintaining office procedures
• Friendly and approachable demeanor

Special Instructions to Applicants:

• For your application for this position to be considered complete, you must upload a resume, and cover letter
• Position consists predominantly of computer work, and the ability to sit for extended periods of time.
• Able to transport himself/herself to various training activities and meetings.
• If you are a Florida resident claiming veteran's preference, please upload a copy of your DD-214 with your application for consideration.
• Overtime compensation as needed based on workload requirements.
• Please note that this position is NOT eligible for remote work.

This requisition is being reposted. All previous applicants are still under review and need not reapply.

Health Assessment Required:Yes

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