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University of Rochester Insur Advisor/Enroll Spec, UHS - 231196 in Rochester, New York

Insur Advisor/Enroll Spec, UHS Job ID 231196

Location Central Administration Full/Part Time Full-Time Favorite Job Regular/Temporary Regular Opening

Full Time 40 hours Grade 008 University Health Service

Schedule

8 AM-5 PM

Responsibilities

General Purpose:

Responsible for managing health insurance enrollment for students, spouses/partners, dependent children and visiting Scholars. Maintain data on UR Student, PyraMed and with the UR Student Health Insurance Plan (SHIP) (Aetna) third party administrator. Coordinate the annual University-wide insurance waiver/enrollment process. Respond to students, parents and other University office inquiries. Advise students regarding health insurance selection and utilization. Assist students with referrals, claim denials, prior authorizations and other billing concerns as needed. Manage billing and collections for the student health program. Manage the importing and exporting of secured file transfers between UHS and Aetna Student Health (ASH). This position requires a high level of customer service, data accountability, use of independent judgment, coverage decision authority, continuous learning, and knowledge of the unique requirements of the university eligible student community and the practices and programs of its six independent schools.

Reports to:

UHS Billing Administration Manager.

MACHINES AND EQUIPMENT USED:

Standard office equipment including computers and software, with an emphasis on database manipulation, analysis and secure file transfer.

Specific Responsibilities: Under general direction and with some latitude for independent judgment:

  • Coordinate the University’s annual open enrollment/hard waiver insurance selection period activities. Monitor on-line system processes. Problem-solve student selection problems. Provide advanced eligibility knowledge to the UR SHIP (Aetna) third party administrator team. Coordinate insurance enrollment due to qualifying life events or early termination requests. Assess eligibility, manage applications, collect fees and transfer enrollment information to the UR plan vendor. Assist and make suggestions for updating yearly enroll/waiver forms. 25 %

  • Represent the UR SHIP (Aetna) and serve as the primary Student Insurance Advisor to students, parents, and other members of the University community regarding eligibility guidelines and plan coverage for the University sponsored student health plan. Serve as student advocate for insurance, billing, referrals, health fees, & navigating the health care system. Mentor others in using resources such as websites and insurance member services. Assist students with online enroll/waive process through the Aetna Student Health enrollment site. 20%

  • Organize & manage insurance enrollment & disenrollment applications for students, dependents, visiting scholars. Prepare payments for premiums paid to insurance carrier. Register new subscribers on UHS departmental medical e-record, PryaMed. Manage enrollment entry and electronic transmission of secure update files. 20%

  • Manage Spouse/Dependent health & insurance fee billing. Retrieve periodic Spouse/Dependent Enrollment file from Aetna’s website using secure file transfer. Verify and analyze using three different database sources (PyraMED, UR Student, and Aetna’s website). Verify the primary subscriber is registered appropriately to enroll in UR SHIP (Aetna) and has been billed for the insurance for the semester/quarter (UR Student). Verify on Aetna’s website that the student and dependent(s) are enrolled in UR SHIP (Aetna). Register the spouse to PyraMED if not a current patient. Bill for dependent health & insurance fee in PyraMED following billing guidelines. Set up alerts in P5 to bill spouse/dependents/voluntary enrollees.10 %

  • Interact with university colleges and departments on student’s status or change in status & adjust status records on a continuing basis. Work closely with the Bursar & Registrar offices regarding health fees, bills and student status. Receive change of status forms by updating P5, UR Student, and ASH files. 10 %

  • Field phone calls from student and spouse dependents regarding backdated referrals, coverage questions and claim denials. 5%

  • Audit UHS charges to be billed on the student’s University account.

  • Analyze list of items to be billed to student university accounts to verify that all charges are appropriate from data extracted from PyraMED by UHS analyst/programmers. This includes checking that all items were billed to the student’s health insurance if appropriate and assuring that the student is only billed for items not otherwise covered. Verify that charges for the mandatory health fee and insurance are the correct dollar amounts based on the type of student and term of registration. 5 %

  • Handle special projects from leadership as assigned, including but not limited to University orientations, tabling events, Flu Clinics, HPV clinics and other administrative duties associated with these special projects. 5%

  • Other duties as assigned.

    Qualifications:

Associates degree in related discipline with 3-5 years of related experience, preferably in medical office insurance and billing, or an equivalent combination of education and experience. Excellent communication and organizational skills; the ability to clearly express ideas and information both orally and in writing; ability to work with people both in person and by phone; interest in and knowledge of the University is essential. Experience working with medical information systems and/or electronic health records required. Working knowledge of Microsoft Office, Excel, PyraMed System (EHR), UR Student, Aetna Student Health, Aetna-SFTP Electronic file transport, e-Record and RHIO.

How To Apply

All applicants must apply online.

EOE Minorities/Females/Protected Veterans/Disabled

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