Medical Insurance and Billing Specialist

Job Summary

The University of Colorado Boulder invites applications for a Medical Insurance & Billing Specialist! This role will complete billing claims accurately and in a timely manner to receive reimbursement for services. In collaboration with Medical Operations and Compliance, this position is responsible for collecting clinical, demographic, and insurance data necessary to complete a claim. The role works with insurance companies, clearinghouse, and other outside entities to coordinate billing and reimbursement and will follow up on claims not paid and/or denied.

What Your Key Responsibilities Will Be

Billing

• Complete and submit claims to insurance or payer using Navicure software.
• Verify insurance eligibilities prior to completion to ensure claim acceptance.
• Verify completeness and accuracy of all claims prior to submission.
• Work closely with Administrative units and providers to collect data needed for claims.

Manage Payment Accuracy

• Accurately post all insurance payments by line item.
• Work with the University Bursar office for assigned charges.
• Use monthly aging accounts receivable reports to follow up on unpaid claims according to billing cycle time frames.
• Correct errors made by payee or identified through clearing house.

Insurance Support

• Read and interpret insurance explanation of benefits related to student billing.
• Check insurance payments for accuracy and compliance with contracts.
• Work with payer regarding any discrepancy in payments if necessary.
• Interpret insurance policy.
• Assist students in understanding their benefits for commercial and/or campus insurances.
• Actively promote and sell campus insurances by engaging in campus events, orientations, and direct communication.

Denials

• Follow up on insurance claim denials, exceptions, or exclusions.
• Contact insurance companies if claims are inaccurate and determine if claim can be reprocessed with additional information.

Customer Service

• Provide excellent customer service to patients, insurance, and staff while following HIPPA guidelines when discussing payments/adjustments/denials.
• Assist patients and staff by educating them on insurance processes and requirements; including student health insurance plans.
• Make necessary arrangements for medical records requests, completion of additional information requests, etc as requested by insurance companies.
• Respond to inquiries from insurance companies, patients, and providers.
• Confer with Assistant Director to discuss and resolve reimbursement issues or billing obstacles.
• Use reports, dashboards, and benchmarks for trending.