Student Health Billing & Insurance Coordinator

Internal for WSSU Employees

This position will handle administrative oversight of the Student Health Insurance Plan (SHIP) to include student enrollment and working with external and internal partners to reconcile reports for accurate student billing. The position involves helping prospective and current undergraduate and graduate students, as well as their families, with understanding student health insurance programs, fees, and services. This includes communicating policies, procedures, options, requirements, and deadlines through various channels such as phone, email, and online platforms.

Knowledge - Program:

1. Reconciles all claims with Explanation of Benefits reported by third party administrators as needed.

2. Processing insurance claims for students enrolled in designated insurance plans who receive covered services in the Wellness Center

3. Administer the mandatory student health insurance program( SHIP), ensuring compliance and effective service delivery. Manage all aspects of mandatory student insurance enrollment and waivers, including coordinating with Athletics Compliance to ensure proper enrollment for student-athletes. Responsible for reporting waivers/appeals to internal and external departments.

4. Reconcile insurance accounts and perform weekly uploads to maintain accurate student eligibility records.

5. Coordinate with the Offices of the Registrar and Student Accounts to ensure proper billing, resolve discrepancies and address student concerns in a timely manner.

Information/Records Administration:

1. Balance insurance claim receipts, refile claims when needed, and collect delinquent revenue. Balance insurance receivables and post to appropriate accounts. Extract reports from the EHR determine which insurance claims are ready to file. Prepare insurance claims for processing through the EHR on a regular schedule.

2. Develop and deliver materials through various platforms, including in-person sessions, online content, and social media, to educate stakeholders throughout the academic year. Verify billing requirements, update accounts, and address inquiries related to student accounts and coverage.

Information Analysis and Decision - Making:

Functions include filing all charges in a timely and accurate manner to ensure maximum payment, monitoring all claims through clearinghouse, communicating with insurance companies regarding claim status on any unpaid claims, problem solve insurance claim rejections and denials, submission and receipts, matching payments received and posting to the proper student's account. Respond to inquiries, analyze documents, and resolve eligibility and coverage-related issues.

Problem Solving:

1. Proactively communicates with insurance company and clearinghouse representatives to resolve claims processing problems.2. Addresses insurance issues as they are received in person or via telephone, email, letters, faxes, etc.3. Actively participates in issue-specific promotional activities ( SOAR, target group orientations, etc.)4. Serves on in-house and campus committees as requested or assigned and represents the student health insurance program.

Communication:

1. Independently, answers student questions about claims in process, plan coverage, and assists students with problems associated with delayed claims, including email and phone communications with the third-party claims administrator to resolve specific problems.
2. Communicates effectively with the Business Officer about insurance, claims and website maintenance processes and problems.
3. Provides information and answers questions about the UNC system-endorsed health insurance plan, the insurance requirement, and the insurance submission process to campus groups, at SOAR, and in other venues.
4. Assists co-workers as needed by preparing comprehensive packets to support insurance appeal recommendations.
5. Communicates appeal decisions via email to students.

6. Cross-train the non-clinical staff on medical insurance billing procedures

A.H. Ray Student Health Services, Room 249

8 am -5 pm; occasional evenings and weekends

Bachelors degree

12 months

Internal for WSSU Employees

Please Note: A criminal background check will be conducted on candidate finalist prior to the offer of employment.

If no applicants apply who meet the required competency and T&E requirements, then management may consider other applicants. Salary would be determined based on competencies, equity, budget, and market considerations.

Resumes will not be accepted in lieu of completing an electronic application. The application must be competed in full detail (including work history) for your qualifications to be considered.

Failure to complete the application completely may result in you not being considered for the vacant position.

Your application for the position will not be complete until you receive an online confirmation number at the end of the process of applying for a position.

Winston Salem State University is an equal opportunity and affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, gender identity, age, sexual orientation, genetic information, status as an individual with a disability, or status as a protected veteran and National Guard.

If you have general questions about the application process, you may contact Human Resources at OHR@wssu.edu. Individuals with disabilities requiring disability-related accommodation in the application and interview process, please call 336-750-2834