- Oversee the smooth operation of the enrollment and waiver process during open enrollment periods each academic year.
- Verify all students' private insurance coverage and identify students eligible for participation in the student medical insurance plan; monitor and update changes to student health coverage.
- Assess the adequacy of student medical insurance and make recommendations for changes as needed.
- Analyze utilization data to identify and track trends in healthcare delivery, industry practices, and government standards and policies; make recommendations for changes if warranted.
- Collaborate with the insurance company to address student questions, concerns, and related processes.
- Establish service standards for the front office staff when dealing with students, parents, faculty, and staff regarding health requirements, including insurance enrollment processes, immunization requirements, and the use of medical office software (e.g., appointments for four providers, calendar updates, patient chart organization).
- Develop a regular feedback mechanism to keep the student health insurance plan administrators informed of concerns or issues.
- Ensure accurate transmission of enrollment data to third-party administrators.
- Oversee the verification of billing and coding performed by Compumed Medical Billing Services and PyraMed medical software.
- Bill student accounts for services not covered by their primary insurance.
- Resolve medical claims by calculating benefits due or by initiating student account billing through patient billing chart review, medical coding, and insurance filing to the university-sponsored student insurance plan.
- Work with the insurance company regarding exceptions to student enrollment (e.g., allowing insurance on a per-semester basis).
- Assist the Student Health Services director in preparing summary financial and insurance enrollment reports as needed for the AVP Residential Life, AVP of Finance, the student insurance company, and the Student Health Insurance Committee.
- Develop publications and update websites to inform students, their parents, and dependents (where applicable) about their health insurance coverage.
- Serve as a liaison with Student Financial Services, Orientation, Student Information Systems, athletic and academic programs for coordinating operational procedures that cross divisional lines.
- Partner with the Athletic department to ensure compliance with university insurance policies and procedures, communicate student athlete insurance requirements, and verify and maintain insurance information for all student athletes.
- Manage financial and accounting processes related to the student health insurance plan by:
- Ensuring all enrolled students are charged the correct insurance rate on their student account.
- Adjusting insurance charges on student accounts as appropriate when waivers or policy terminations are approved.
- Reconciling monthly insurance company billing with insurance charges on student accounts on a student-by-student basis.
- Maintaining insurance service indicator data on each student account to ensure it matches decision data at the university through the student insurance waiver system for all students living in campus housing and all F-1 and J-1 international students.
- Serve as the primary liaison and coordinator between the insurance carrier, medical providers, and student-athletes regarding athletic-related injuries, claims, and billing statements.
- Review and approve insurance claims and medical bills related to a student-athlete's sports injury.
- Assist in reporting any injuries that meet the FICURMA mandatory reporting requirements to the Office of Legal Affairs.
- Assist the Director in managing the administrative functions of the Student Health Services, focusing on the day-to-day operations of the non-medical aspects of the department.
- Ensure compliance with FERPA and HIPAA regulations in all applicable processes and recordkeeping.
- Bachelor's degree in Healthcare Administration, Business Administration, Public Healt, or a related discipline is required.
- 3-5 years of related experience required.
- Must be proficient at patient billing and patient accounting principles.
- Must be experienced with patient billing, medical office processing including health information systems and insurance claim management.
- Advanced skills with MS Office Suite
- Experienced using EMR and billing systems.
- Must have a high level of communication skills in order to provide excellent customer service and explain clearly and concisely pattient issues.
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Student Health Services Operations Manager - Miami Shores, United States - Barry University
Description
SummaryThe Student Health Services Operations Manager oversees the comprehensive management of various student insurance plans, including the Student Medical Insurance Plan, IC sports plan, master student accident plan, cheer, and club sports policies. This role entails supervising enrollment and waiver processes, coordinating benefits and claims related to the IC sports plan, and facilitating exceptional customer service and communication. The Operations Manager collaborates closely with Athletics, Accounts Payable, Purchasing, the Student Health Services team, and the Student Insurance provider to ensure seamless and efficient operations.
Additionally, this role serves as a liaison and advocate for students, fostering regular communication and promptly addressing any concerns. The Operations Manager is also responsible for onboarding and supervising the front desk administrative assistant, including providing coverage at the front desk as needed.
The Operations Manager handles financial and accounting responsibilities through Colleague, by billing resident and international students for students' insurance, ensuring students who waive the student health plan are credited expeditiously and working with the AIS liaison to ensure proper transmission of students billed for the SHIP from Colleague to waiver management company.
The Operations Manager handles financial and accounting responsibilities through Workday such as managing accounts payable and receivable transactions, maintaining contracts, generating purchase orders and supplier contracts, and processing vendor payments. This multifaceted role plays a key part in the smooth functioning of the Student Health Services Department.
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Barry University is an Equal Opportunity Employer, committed to a diverse and inclusive work environment.