Job Details

Medical Insurance & Billing Specialist

Position Number: 6051541
Location: Boulder, CO
Position Type: Health and Medical Services

Medical Insurance & Billing Specialist

Requisition Number: 62514
Location: Boulder Colorado
Employment Type: University Staff
Schedule: Full Time
Posting Close Date: 18-Mar-2025
Date Posted:

Job Summary

The Health and Wellness department at CU Boulder encourages applications for a Medical Insurance & Billing Specialist! Under the direction of the Assistant Director for Billing & Coding, the Medical Insurance & Billing Specialist is responsible for completing billing claims accurately, completely, and timely in order to receive reimbursement for services. In collaboration with Administrative Services, the Medical Insurance & Billing Specialist is responsible for collecting clinical, demographic, and insurance data necessary to complete a claim. The Medical Insurance & Billing Specialist works closely with insurance companies, clearinghouse, and other outside entities to coordinate billing and reimbursement and to follow up on claims not paid and/or denied. The Medical Insurance & Billing Specialist is responsible for accurately posting reimbursement in the electronic billing system and for follow up when reimbursement is in accurate or incomplete.
The Medical Insurance & Billing Specialist provides excellent customer service for patients by answering questions about insurance processing or status of a claim. This includes, but is not limited to, assisting students with their questions and claims issues as well as reviewing, evaluating and updating claim payments reflected by the student insurance plan. The Medical Insurance & Billing Specialist will review medical records and charges and determine if it is necessary to contact insurance companies to discuss the type of plan the student has. The Medical Insurance & Billing Specialist must understand the insurance terms as well as how to interpret an explanation of benefits (EOB).
The Medical Insurance & Billing Specialist will provide clear expectations of policy details to students, faculty, and staff helping them understand coverage limitations, eligibility criteria, and benefits of our campus student health insurance plans Gold and BuffCare. The Medical Insurance & Billing Specialist will interpret and apply health insurance policies to ensure students and our institution follow relevant laws and legislation. The Medical Insurance & Billing Specialist will assist students with understanding their health insurance options, including coverage details, benefits, and out of pocket costs. The Medical Insurance & Billing Specialist will actively promote and sell the campus student health insurance plans Gold and BuffCare to students and their families. The Medical Insurance & Billing Specialist will engage with students during orientations, campus events, and through direct communication to encourage enrollment in the campus student health insurance plans Gold and BuffCare.
The University of Colorado Boulder is committed to building a culturally diverse community of faculty, staff, and students dedicated to contributing to an inclusive campus environment. We are an Equal Opportunity employer, including veterans and individuals with disabilities.

Who We Are

Administrative Services staff in Health and Wellness understand and are committed to the unique health concerns of our student population, making us an unparalleled source of advocacy for student wellness at CU Boulder! The Wardenburg Medical Clinic provides a wide range of health care services for students including: primary care for illnesses and injuries, as well as chronic conditions, physicals, sexually transmitted infection testing and treatment, allergy shots, vaccinations, travel health care, and concussion care.

What Your Key Responsibilities Will Be

Billing

Complete and submits 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 need for claim.
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 (EOB) 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 orientations, campus events, and through direct communication.

Denials

Follow up on insurance claim denials, exceptions, or exclusions
Contact insurance companies if claims are inaccurately 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 to insurance processes and requirements; this includes the student health insurance plans.
Makes 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.
Uses reports, dashboards, and benchmarks for trending.

What You Should Know

The anticipated work schedule for this position is Monday - Friday, 8 am - 5 pm. This role is not expected to work University recognized holidays or evenings and will not be on call at any time.
This position will be in person for training purposes, and will have the opportunity to move to a hybrid work schedule after training is completed.

What We Can Offer

The salary for this position is $52,000 annually.

Benefits

The University of Colorado offers excellent benefits, including medical, dental, retirement, paid time off, tuition benefit and ECO Pass. The University of Colorado Boulder is one of the largest employers in Boulder County and offers an inspiring higher education environment. Learn more about the University of Colorado Boulder.

Be Statements

Be game-changing. Be respectful. Be Boulder.

What We Require

Two years of relevant professional experience. Appropriate education will substitute for the required experience on a year-for-year basis.
Certification related to the work assigned to position will substitute for the required experience.

What You Will Need

Basic insurance billing knowledge.
Customer Service skills.
Ability to contact insurance companies to discuss the type of plan the patient has.
Make decisions related to posting medical charges.

Special Instructions

To apply, please submit the following materials:

A current resume.
A cover letter that specifically tells us how your background and experience align with the requirements, qualifications, and responsibilities of the position.

We may request references at a later time.

Please apply by March 18, 2025 for consideration.
Note: Application materials will not be accepted via email. For consideration, please apply through CU Boulder Jobs.

In compliance with the Colorado Job Application Fairness Act, in any materials you submit, you may redact or remove age-identifying information such as age, date of birth, or dates of school attendance or graduation. You will not be penalized for redacting or removing this information.

To apply, visit https://jobs.colorado.edu/jobs/JobDetail/Medical-Insurance-Billing-Specialist/62514