Clinical Services Representative II – Student Health Care Center

2 months ago

Gainesville, United States University of Florida Full time

Job Description:

The University of Florida's Student Health Care Center (SHCC) within the Department of Community Health and Family Medicine (CHFM) is hiring a Clinical Services Representative II. This role focuses on managing denied insurance claims, reconciling patient accounts in EPIC with the UF Bursar, and providing exceptional service to a diverse student population. Responsibilities include answering calls, directing inquiries, assisting patients with billing and insurance questions, and ensuring accurate and timely billing processes. The position also involves charge entry, verifying insurance, obtaining authorizations, and offering financial counseling to patients, all aimed at delivering patient-centered care.

Financial Support

• Facilitate established financial processes to expedite billing and collection of professional services.

• Enter charges, apply basic coding/billing rules, and maximize collections.

• Verify insurance and obtain necessary authorizations for services.

• Review patient account details and provide financial counseling to patients.

• Resolve front-end edits, rejections, and information requests to meet practice goals.

EHR Support

• Review and update patient account details in the EPIC system.

• Verify insurance and obtain consent forms, identification, and other required documentation.

• Confirm student status/eligibility for services and assign the correct guarantor for appointments.

• Ensure proper scanning, labeling, and placement of paper documents in the correct section of the EPIC electronic health record (EHR).

• Engage effectively with a diverse student population, addressing varied healthcare needs.

Denied Claims

• Troubleshoot, research, and correct denied claims to ensure they are clean, reprocessed, or written off as necessary. Leadership and Insurance Support

• Serve as lead in the Insurance Department, verifying insurance and setting up new patient accounts in EPIC.

• Assist with insurance updates in EPIC at the start of each quarter.

• Act as an in-house insurance educator, providing support and guidance to staff on insurance processes and EPIC application.

Mics. Duties:

• Cover for Operator when necessary.

The Clinical Service Representative will also assist with other duties and projects as necessary.

Clinic Hours and Schedule Information:

The clinic is open Monday through Friday, 8: a.m. to 5: p.m., Sunday clinic during the fall and spring semesters. Scheduled hours and days can vary according to the SHCC’s needs.

At Community Health and Family Medicine and its divisions, everyone belongs, grows, and thrives

The University of Florida is an Equal Opportunity Employer. The University is committed to nondiscrimination with respect to race, creed, color, religion, age, disability, sex, sexual orientation, gender identity and expression, marital status, national origin, political opinions or affiliations, genetic information, and veteran status in all aspects of employment including recruitment, hiring, promotion, transfers, discipline, terminations, wage and salary administration, benefits, and training.

Clinic Hours and Schedule Information: The clinic is open Monday through Friday, 8: a.m. to 5: p.m., Sunday clinic during the fall and spring semesters. Scheduled hours and days can vary according to the SHCC’s needs. 

About Gainesville, Florida:

Gainesville () is home to Florida's largest and oldest university and serves as one of the state's centers of education, medicine, cultural events, and athletics. Gainesville is also the largest city in Alachua County and is the county seat, with approximately , residents county-wide. The city provides a full range of municipal services, including cultural and nature services and necessary administrative services to support these activities. Additionally, the city owns a regional transit system, a regional airport, and a -par championship golf course. Known for its preservation of historic buildings and the beauty of its natural surroundings, Gainesville's numerous parks, museums, and lakes provide entertainment to thousands of visitors. Because of its beautiful landscape and urban "forest," Gainesville is one of the most attractive cities in Florida. It is a hidden gem in North Central Florida that is within a couple of hours of major cities such as Orlando, Jacksonville, and Tampa. We are in a central location to the Gulf of Mexico and the Atlantic Ocean, providing easy access within a day’s drive to beaches, nature preserves, and water-based activities. We have warm weather much of the year, allowing for outdoor activities almost year-round. Due to the diverse atmosphere generated by The University of Florida and UF Health Shands, who are the leading employers in Gainesville, Gainesville is also a wonderful place to raise a family. For more information about Gainesville, FL, please go to: .

Expected Salary:

$. to $. 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: Ability to adhere to high standards of customer service as the position involves extensively telephone and face-to-face interaction with patients, health care providers, and staff from various SHCC offices. Possess excellent communication, organization, and problem-solving skills. Must be comfortable discussing personal health information in a confidential, professional manner. Business or healthcare-related practice experience. The ability to multi-task, prioritize responsibilities, problem-solve, and function in a team environment. EPIC system knowledge Knowledge of CPT, HCPCS, and ICD- Working knowledge of WayStar and Availity Ability to adhere to UF and UF Health policy. Completion of required annual training including but not limited to HIPAA, FERPA, Red Flags, Handling SSN, Billing Compliance

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