Job description
University of Colorado | CU Anschutz Medical Campus
School of Dental Medicine
Job Title Insurance Specialist/Accounting Professional - 2388
Position #00706744 – Requisition #27227
* Applications are accepted electronically ONLY at www.cu.edu/cu-careers *
The University of Colorado has a requirement for COVID-19 vaccinations and full completion thereof by 9/1/21 or upon start date. Information regarding this requirement, and exemptions can be found at:
Exemptions vary by campus location/department.
Campus/Unit-Specific Exemptions:
- Anschutz Campus – Exemptions are allowed for medical or religious reasons.
- Denver Campus - Exemptions are allowed for medical, religious, or personal reasons.
- Consolidated/Central Services Administration – Will follow Anschutz policy on exemptions.
The University of Colorado Anschutz Medical Campus seeks individuals with demonstrated commitment to creating an inclusive learning and working environment. We value the ability to engage effectively with students, faculty and staff of diverse backgrounds.
The School of Dental Medicine has an opening for a full-time, University Staff (unclassified) Insurance Specialist position.
The University of Colorado Anschutz Medical Campus is a public education, clinical and research facility serving 4,500 students, and a world-class medical destination at the forefront of life-changing science, medicine, and healthcare. CU Anschutz offers more than 42 highly rated degree programs through 6 schools and colleges, and receives over $500 million in research awards each year. We are the single largest health professions education provider in Colorado, awarding nearly 1,450 degrees annually. Powered by our award-winning faculty, renowned researchers and a reputation for academic excellence, the CU Anschutz Medical Campus drives innovation from the classroom to the laboratory to the delivery of unparalleled patient care. Read CU Anschutz Quick Facts here.
(NOTE: Career family definition, level definition and position emphasis in the job description above will be included in posting here.)
Job Responsibilities
This full-time, University Staff (non-classified) position is responsible for the timely and accurate billing and payment processing of all third-party insurance, Medicaid, and special programs. Duties include completing all necessary manual and automated documentation to facilitate the authorization for dental services. Processes and posts insurance payments, adjustments, rebills, and denials. Establishes and maintains benefit plan information in the system. Responds to inquiries and uses various software applications and information system to perform work processes.
Insurance Processing and Coordination – 100% (Essential Function)
- Assure proper reimbursement for care provided and/or collect revenue for dental procedures by coding/billing, insurance collections and payment verification. Requires knowledge of insurance contracts and dental coding.
- Responsible for establishing and documenting operational standards, fiscal reporting, communication with clinic managers, and financial management.
- Must be comfortable working with Electronic Health Records and have a high proficiency with Microsoft Office applications.
- Delivers successful service to our internal and external customers by adhering to critical success standards; demonstrating accountability and commitment to quality and safety standards; taking ownership in the financial success of the School of Dental Medicine with appropriate resource use and management; providing exceptional customer service; and exerting an effort to insure a positive work environment.
- Verifies eligibility and benefits, and coordinates insurance benefits for all appropriate patient visits.
- Obtains authorization for treatment and/or precertification of treatment as required.
- Ensure all second- and third-party payer requirements are met in order to optimize reimbursement.
- Explain and enforce School of Dental Medicine and Patient Accounting Department’s financial policy to internal and external customers.
- Advise patients on financial payment responsibilities and dental insurance policies, clarifying what various policies will and will not cover.
- Seek assistance for unusual or difficult situation and or issues.
- Conduct phone interviews with patients to obtain financial/insurance data.
- Review, analyze and verify information for accuracy.
- Enter data into the School of Dental Medicines axiUm computer system. Collect data and prepare reports as requested
- Identify process issues and opportunities to discuss with Supervisor
- Advise patients, residents, students, faculty and staff in regards to insurance questions on patient accounts.
- Act as back up to Patient Accounting Department cashiers for obtaining patient insurance information for verification of eligibility and benefits.
- Attach insurance template to patient record or create “new” template in clinic computer system.
- Responsible for the timely and accurate submission of dental insurance/Medicaid for completed patient services. May submit electronically, by paper or other external third-party systems.
- Provide payers with necessary documentation and written response to address inquiries and appeals.
- Perform regular maintenance to ensure the accuracy of insurance groups and benefit plans.
- Proactively manage patient accounts by identifying pre-authorization opportunities to maximize payment for the patient for all insurance carriers, including Medicaid. Coordinates and process payments from insurance carriers and troubleshoots any issues related to these payments. Receives additional information requests from insurance carriers.
- Resolve discrepancies by examining and evaluating data, gathers the necessary information, and forwards to insurance carrier.
- Review and research claim denials/payments/adjustments and explanation of benefit statements.
- Ensure coordination of benefits are accurate when applicable.
- Serve as liaison between insurance carriers, patients, students, faculty, and staff to resolve any concerns and maintains a positive working relationship.
- Monitor insurance claims by running appropriate reports and contacting insurance carriers to resolve claims that have not paid in a timely manner.
- Maintain up-to-date knowledge of regulations and laws related to the insurance industry.
- Demonstrate understanding of the patient’s treatment plan, corresponding charges and insurance status to respond to questions/concerns.
- Update and notify patient accounting staff of any changes in any insurer’s rules and regulations.
- Ensure all insurance related duties are completed in a timely and accurate manner to ensure excellent patient relations.
- Demonstrate HIPAA compliance and patient rights’ while providing outstanding customer service in person, by mail or on the phone.
- Ability to work with a variety of individuals and groups in a constructive manner.
- Ability to utilize resources such as axiUm, ORM, patient accounting policies to achieve or exceed desired outcomes of current or future organizational goals/needs.
- Assist in the training of any SDM Staff in all aspects of the insurance processes.
Other Duties – (Non-essential Function)
On occasion, this position may be assigned other duties needed to help drive to the vision, fulfill the mission, and uphold the organizational values of CU Denver/Anschutz and the SDM.
Minimum Requirements
- A Bachelor’s degree from an accredited college or university in Business, Accounting or related field and one year of insurance experience in a medical/dental setting.
- Professional accounting experience may substitute for on a year-for-year basis for the degree requirement, but not for the one year of insurance experience in a medical/dental setting.
Preferred Qualifications
- Dental terminology
- Experience that reflects familiarity with PPO/EPO, Medicaid, and the American Dental Association (ADA) Code on Dental Procedures and Nomenclature
- Experience that reflects working with electronic health records and insurance processing in either a medical or dental setting
- Experience with CDT dental coding and dental terminology
Competencies
- Exceptional interpersonal skills
- Demonstrated ability to communicate and maintain positive interpersonal relationships within a diverse community
- Excellent written and verbal communication skills
- Strong organizational skills
- Excellent computer skills
- Excellent understanding of verifying, authorizing and processing of insurance claims
- Knowledge in federal and state regulations
- Excellent written and verbal communication skills
- Experience with Word, Excel and Outlook
Communications
Interaction with faculty and staff on a daily basis. Strong communication skills and problem-solving skills for dealing with a variety of personalities and various levels of stress at times.
Salary and Benefits
The annual salary range (or hiring range) for this position has been established at $44,325 to $50,000.
The salary of the finalist(s) selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training.
The above salary range (or hiring range) represents the University’s good faith and reasonable estimate of the range of possible compensation at the time of posting.
This position is not eligible for overtime compensation.
Your total compensation goes beyond the number on your paycheck. The University of Colorado provides generous leave, health plans and retirement contributions that add to your bottom line.
Benefits: https://www.cu.edu/employee-services/benefits
Total Compensation Calculator: http://www.cu.edu/node/153125
Diversity and Equity
The University will provide reasonable accommodations to applicants with disabilities throughout the employment application process. To request an accommodation pursuant to the Americans with Disabilities Act, please contact the Human Resources ADA Coordinator at hr.adacoordinator@ucdenver.edu.
The University of Colorado Denver | Anschutz Medical Campus is committed to recruiting and supporting a diverse student body, faculty and administrative staff. The university strives to promote a culture of inclusiveness, respect, communication and understanding. We encourage applications from women, ethnic minorities, persons with disabilities and all veterans. The University of Colorado is committed to diversity and equality in education and employment.
The University of Colorado Denver | Anschutz Medical Campus is dedicated to ensuring a safe and secure environment for our faculty, staff, students and visitors. To assist in achieving that goal, we conduct background investigations for all prospective employees.
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