Campus Insurance Lead

How to Apply

A cover letter is required for consideration for this position and should be attached as the first page of your resume. The cover letter should address your specific interest in the position and outline skills and experience that directly relate to this position.

Job Summary

Department Summary:

The Managed Care/Campus Insurance office administers the U-M Domestic Student Health Insurance plan, the U-M Tuition Ins. plan, and the U-M Travel Abroad Health Insurance plans.  The department also assists with Medicaid enrollment.  

Position Summary:

Responsible for training of the departments Patient Business Associates and serves as a subject matter expert on the specifics of the U-M student insurance, tuition insurance and travel abroad insurance plans, and Michigan Medicaid. The Campus Insurance Lead answers phone calls, email replies, and provides in-person presentations to students, parents, UHS clinicians and U-M faculty and staff about UHC and the insurance plans we administer. 

Responsibilities*

Member Service (70%)

• Provides insurance information and interprets the benefits, coverage, eligibility and costs of the U-M domestic student insurance, U-M tuition insurance, the U-M Travel Abroad Health insurance, Mi Medicaid enrollment and UHS information to U-M students, parents, faculty and staff.
• Respond to inquiries received through phone, mail, email or zoom based from patients, providers, U-M departments or insurance providers.
• Research individual patient coverage and benefits detail via payor websites, direct contact with company representatives, insurer's Certificates of Coverage, Benefits at a glance documents, Member Guide documents, fee schedules & other benefit information.
• Provide coverage and benefit details related to each company's products or services using insurer's Certificates of Coverage and Member Guides and procedures. Act as liaison between patients, clinical staff members, University Departments, U-M employee benefit plans, International and Domestic student insurance company, the U-M Tuition Refund Insurance, the U-M Travel Abroad Insurance plans, MI Medicaid and other health insurance companies and provide detail for all inquiries.
• Assist medical providers and their billing staff (both in MI and outside of MI) with insurance coverage information for members of the U-M domestic and international student health insurance with whom they will provide or have already provided medical care for.
• Support UHC Patient Business Office in providing patient liability estimates using procedure cost, procedure codes, diagnosis and insurer's certificate of coverage.
• Research member's claims, including charges that should have been covered by insurance and overdue member balances.  Coordinate review of charges with members, servicing providers and health insurers to assist with patient balances and payments.  
• Educate patients regarding insurance benefits and patient liability for hospital and professional services.
• Provide direction and coverage information to participating and non-participating medical provider offices (including referral coordinators, authorization depts, and check-in staff) regarding member copayments, coinsurances, referrals, authorizations and insurer payments, as requested.
• Seek additional advice and assistance from the UHC Billing Office, the Michigan Medicine (MM) Billing Office and MM Patient and Financial Counselors for complex cases.
• Act as a liaison between UHC patients (students, faculty, staff, retirees, spouses, and dependents), UHS clinicians, University Departments, Domestic/International student insurance plans, Tuition Refund Insurance, U-M Travel Abroad Health Insurance, and other insurance companies regarding health care coverage and benefit interpretation.
• Review and analyze medical record information including but not limited to past therapies and obtaining Third Party Administrator approval/authorization for further treatment.
• Evaluate, compile medical documentation, review medical chart notes, and obtain additional support documents from non-UHS facilities as requested. Create letters of medical necessity for approval, identify exceptions and document special conditions for Medical, ME coverage for benefits under providers and non-par providers outside of service area.
• Create and maintain activity logs, compile data, and provide reports on a regular cadence.
• Assist other Managed Care/Student Insurance staff as available
• Assist in coordination of care including advice regarding alignment of STAT/Urgent patient visits, procedures, radiology/imaging and diagnostic/therapeutic studies.
• Support STAT/Urgent scheduling alignment, complete service requisitions, and complete special service diagnostic/medical information requests from providers and insurance companies. Support any necessary documentation including insurance referrals and authorizations.
• Assist patients with urgent and emergent referrals to outside facilities.
• Evaluate the type of service requested and urgency of identified problems for referrals.
• Monitor provision of scheduled STAT/Urgent non-UHS services, which may include obtaining and providing results/notes to ordering clinician.
• Assist U-M students with Michigan Medicaid enrollment

Lead Duties (30%)

• Responsible for training specifically on campus insurance and provides new hire orientation for the department's Patient Business Associates.
• Serves as a subject matter expert on the specifics of the U-M student insurance, tuition insurance and travel abroad and MI Medicaid insurance plans.
• Serve as escalation lead when students and or parents need additional information or consultation; serving as the primary point of contact before manager involvement beyond what the frontline staff can deliver.
• Prior to new plan year, work with UHC or AVP's Communication Lead to update all UHC webpages for insurance plans and pages associated with insurance.
• Preparation of departmental insurance reference sheets and resources including other university stakeholder contact information  and plan information that changes regularly
• Prior to new plan year, work with all insurers to update and edit flyers, mailings, member guides, BAAG's, reference sheets and other plan materials
• Arrange summer early arrival insurance coverage and short-term carry-over plan. 
   

Required Qualifications*

• High school diploma
• A minimum of four years experience working with health insurance in a healthcare facility
• Telephone appointment scheduling experience
• Demonstrated ability to function as a subject matter expert with regard to insurance benefits and cost sharing
• Basic knowledge of medical terminology
• Basic computer and data entry skills
• Customer service skills
   

Desired Qualifications*

• Knowledge and experience of the U-M student health insurance plans and the U-M benefits plans or prior experience with campus insurance offerings in an academic setting
• Demonstrated ability to be effective in a fast-paced medical setting.
• Demonstrated ability to work independently and as a member of a team.
• Demonstrated ability to multi-task and problem solve.
• Bi-lingual or multi-lingual skills desired.
• Familiarity with BCN WebDenis/EReferrals, Availity, Navinet, MI Bridges and MiChart
• Knowledge of third-party reimbursement, policies and procedures
• Proficiency in MiChart, Outlook, Microsoft Word, Excel, PowerPoint, Google software, Zoom
• Experience with medical terminology and human anatomy.
• Knowledge of University of Michigan policies and procedures.
• Familiarity with ICD-10 coding
   

Modes of Work

Positions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work agreements are reviewed annually at a minimum and are subject to change at any time, and for any reason, throughout the course of employment. Learn more about the work modes.

Additional Information

Position Responsibilities Criteria (leadership and behavioral qualities expected in this position):

• Demonstrated personal and professional commitment to diversity and a solid understanding of and appreciation for cultural, ethnic, and individual differences.
• Excellent communication, interpersonal, and organizational skills.
• Demonstrated ability to problem solve and be adaptable in a fast-paced environment.
• Demonstrated ability to manage multiple priorities and navigate change effectively.

Financial/Budgetary Responsibility:

• n/a

Working Conditions:

• This is a hybrid position. The staff member mainly works from home but is expected to come to campus for meetings and events as needed.

Physical Requirements:

• n/a

Direct Reports:

• None however, the position leads two Patient Business Associates who work mostly remote.

This role may have reporting obligations under Title IX and Clery.

Authorization to work in the U.S. is a precondition of employment and applicants for this position will not be sponsored for work visas.  

Salary may vary depending on qualifications, experience, and education of the selected candidate.

Selected candidates whose start date is 4/1/2025 or after, will not be eligible for the university FY25-26 salary/merit plan unless otherwise notified.

Relocation will not be offered for this position.

#studentlife
 

Application Deadline

Job openings are posted for a minimum of seven calendar days.  The review and selection process may begin as early as the eighth day after posting. This opening may be removed from posting boards and filled anytime after the minimum posting period has ended.

U-M EEO/AA Statement

The University of Michigan is an equal opportunity/affirmative action employer.