Assistant Director of Student Health Insurance, Medical Billing, and Claims - Morgan State University : Job Details

Posting Summary

Job Title Assistant Director of Student Health Insurance, Medical Billing, and Claims Division Student Affairs Office Department University Health Center Work Status Full Time Position Category Staff FLSA Exempt Pay Range Exempt Salary Range $75,000 - $90,000 / year Fund Source State Support Job Summary

The Assistant Director for Student Health Insurance, Medical Billing & Claims oversees the operations related to the Student Health Insurance Plan and Medical Billing in the University Health Center. This position provides administrative leadership to the front office staff for medical billing and claims; while serving as the liaison for students and their dependents with regard to the Student Health Insurance Plan. Assists in managing workflow to meet deadlines in an effective and efficient manner. This position directly manages the office and third-party billing for all students receiving services; including regular communication with students concerning active benefits and coverage, coordinating insurance program enrollment, maintaining accurate records, reconciling health insurance premiums, and daily, weekly, monthly, and annual medical billing records.

Job Duties

Duties & Responsibilities:

* Regularly collaborates with the Office of the Bursar, Records and Registration, Division of Information Technology, the Student Health Insurance Broker, and the Student Health Insurance carrier, to ensure the Health Insurance waiver and enrollment process is implemented each academic semester and functioning effectively throughout the academic year. Facilitates the enhancement and implementation of the annual waiver process; to include updates of all communication and the University Health Center webpage.

* Provides students with plan benefits and enrollment information regarding Dental and Vision insurance.

* Initiates the Procurement process for competitive bids for Student Health Insurance brokers and carriers prior to the most recent end date of terms based on the contract. Reviews and determines the most effective optional insurance plan for students. Provides assistance in the development of requests for proposals. Submits invoices for payment to the Office of Accounts Payable for processing.

* Coordinates certification of primary insurance status for all full-time undergraduate students. Manages the process with the purchase of primary insurance policies through the Student Health Insurance Plan for uninsured, underinsured, and international students. Develops and issues health insurance-related correspondence for students, parents, providers, and insurance carriers.

* Directly manages and audits In Office and Third Party Medical Billing and Ledger Billing Records for the University Health Center on a weekly and monthly basis. Establishes, implements, updates, and records the procedures for Medical Billing, reviews accounts for errors, and collaborates with the Medical Director or designee to manage the process for corrective action.

* Directly supervises the Medical/Billing Associate. Indirectly supervises the Administrative Staff and Medical Aide(s) in relation to Student Health Insurance and Medical Billing procedures.

* Reviews and updates the Medical Billing module in the Electronic Medical Records (EMR) system, and communicates with the EMR system administrator to troubleshoot any challenges. Operates as the initial contact person for the Medical Billing module.

* Reconciles daily, weekly, monthly, and annual medical billing transactions in the University Health Center. Coordinates with the Medical Director to complete a semesterly and annual review of the Health Center Fee Schedule. Updates the Health Center Fee Schedule semesterly and annually, which includes submitting the updated information to the appropriate parties for processing in the EMR system.

* Reviews claim appeals and coordinates claim review with the Medical Director or designee. Investigate potential improper claim payments and pursue refunds as appropriate Health Insurance Plan semesterly and annually.

* Establishes and updates Student Health Insurance policies, protocols, and standard operating procedures for Student Health Insurance Plans and Medical Billing. Creates monthly and annual reports to support the function and operations of the Student Health Insurance and Medical Billing functions. Implements and monitors fiscal procedures for the University Health Center.

* Develops informational materials and facilitates presentations regarding Student Health Insurance, Medical Billing, and University Health Center services.

* Reviews University Health Center EMR and Insurance Broker software systems to ensure accurate transfer of student data. Investigate potential improper claim payments and pursue refunds as appropriate.

* Other duties as assigned.

Requested Minimum Qualifications

Education

The successful candidate must have a Bachelor's Degree in any discipline from an accredited College or University.

Experience

The successful candidate must have at least five (5) years of progressive work experience in health insurance, medical billing, and claims.

Other Preferences for Consideration Knowledge, Skills & Abilities

Knowledge, Skills, and Abilities

* Thorough knowledge of Student Health Insurance and Medical Billing in a College/University environment and a strong understanding of best practices in health insurance, billing, and claims.

* Must be a progressive strategist that consistently guides the department's processes and procedures toward improvement and success.

* Outstanding and effective verbal and written communication skills as evidenced by the ability to articulate and present in an organized, logical, and professional manner.

* Strong organizational, planning, management, and leadership skills.

* Excellent interpersonal skills with demonstrated ability to interact effectively with students, faculty, staff, and university stakeholders of diverse cultural, social, political, and religious backgrounds, various ages, genders, sexual orientations, and abilities.

* Must be proficient in Health Insurance Claim and Medical Billing processing.