Posting Detail Information

Working TitleInsurance Specialist

Position LocationFort Collins, CO

Work LocationPosition qualifies for hybrid/in-office work

Research Professional PositionNo

Posting Number202402157AP

Position TypeAdmin Professional/ Research Professional

Classification TitleTechnical/Support II

Number of Vacancies

Work Hours/Week40

Proposed Annual Salary Range$43,250-$50,000; Salary is commensurate with experience and qualifications.

Employee Benefits

Colorado State University is not just a workplace; it’s a thriving community that’s transforming lives and improving the human condition through world-class teaching, research, and service. With a robust benefits package, collaborative atmosphere, commitment todiversity, equity and inclusion (https://inclusiveexcellence.colostate.edu/about/) , and focus on work-life balance, CSU is where you can thrive, grow, and make a lasting impact.

• Review our detailed benefits information here. (https://hr.colostate.edu/wp-content/uploads/sites/25/2021/01/benefits-summary-afap.pdf)

• Explore the additional perks of working at CSU here.

• For the total value of CSU benefits in addition to wages, use our compensation calculator (https://hr.colostate.edu/total-compensation-calculator/) .

• Lastly, click here for more information about why Fort Collins is consistently ranked in the top cities to live in (https://hr.colostate.edu/prospective-employees/our-community/) !

Desired Start Date

Position End Date (if temporary)

To ensure full consideration, applications must be received by 11:59pm (MT) on01/05/2025

Description of Work Unit

Student Insurance

The Student Insurance department at the CSU Health Network is dedicated to promoting a culture that is characterized by inclusion, integrity, service, open communications, employee engagement, and mutual respect. The Student Insurance department at the CSU Health Network manages all aspects of the CSU Student Health Insurance Plan ( SHIP ) and supports students enrolled in SHIP through assisting with enrollment, billing and payment of services provided at the Health Network. The department also manages the RamCare program and supports students enrolled in the program with enrollment, billing, and payment of services provided at the Health Network. Additionally, the Student Insurance department administers CSU’s annual student health insurance requirement by assisting students with questions related to the insurance waiver and ensuring all processes related to this requirement flow smoothly. The department regularly works in partnership with other CSU departments, external vendors, outside offices and insurance companies to accomplish these goals. The Student Insurance department provides services between the hours of 8:00 am – 5:00 pm Monday-Friday, providing attractive work schedules for staff.

The CSU Health Network ( CSUHN ) at Colorado State University provides a full range of cost-effective mental health and primary care medical services on campus, referral for community specialty care, and comprehensive health education and prevention services programming. Services such as physical therapy, dentistry, and optometry are available. The CSU Health Network is active in creating a healthy campus environment to support learning and success. For more information about the CSU Health Network at Colorado State University, seehttps://health.colostate.edu/

Why work at Colorado State University?

CSU was recently ranked first among Colorado-based educational employers and fifth among all in-state employers in Forbes magazine’s “America’s Best Employers by State!”

We are looking to add individuals to our team who have the following characteristics:

• Confidence – they expect success in what they do

• Compassion – they have genuine care and concern for others

• Commitment to Inclusive Excellence – they engage principles of diversity, equity, inclusion, and justice in all they do, valuing a supportive community where everyone’s contributions are valued, and all voices are heard

• Empowerment – they use their knowledge and skills to adjust, change, and improve daily tasks/work for themselves and others

• Integrity – they are honest, and others trust them

• Responsibility – they take ownership of decisions and actions

Our Investment in You

Colorado State University ( CSU ) is committed to providing employees with a strong and competitive benefits and well-being package that supports you, your health, and your family.

These CSU resources help with many aspects of your life – financial, physical, emotional, family, workplace wellness. These resources are part of our investment in you.

Employees are benefits eligible when working a minimum of 20 hours per week; benefits outlined below reflect full-time status of 40 hours per week; some benefits would be prorated for part-time status.

• Attractive daytime work schedule that is flexible yet consistent Monday-Friday, with no night or weekend shifts

• Inclusive leave programs and benefit options including:

• Generous amount of paid time off to include 24 vacation days, 15 sick days, 11 paid holidays, annually

• Comprehensive and affordable benefits programs and services including Medical, Dental, Vision, Life, Disability, Parental Leave, work/life resources, and more

• Substantial employer match between 10% – 21% depending on retirement program

• Robust Employee Assistance Program ( EAP ) and Well-Being Hub for your overall well-being

• Discounted staff memberships in campus recreation center

• FREE college credit courses (up to 9-semester credits per year) through the Employee Study Privilege program

• Up to 50% resident, regular on-campus tuition for eligible family members through the Tuition Scholarship Program

• FREE employee growth opportunity through CSU Talent development

• After-school programs and summer camps for kids

• Community Discounts

• FREE MAX transit use with CSU identification

For more detail about these and other Health and Welfare benefits and Commitment to Campus programs, visit our CSU Well-Being Hub athttps://hr.colostate.edu/well-being-hub/and our Benefits programs for Administrative Professional employees:https://hr.colostate.edu/current-employees/benefits/afap/.

Retirement Programs

While employees of CSU do not contribute to Social Security, the University and the state of Colorado offer competitive retirement plans. As a condition of employment and required by Colorado law, employees are required to participate in either the University’s Defined Contribution Plan ( DCP ) or the Public Employee’s Retirement Plan ( PERA ) of Colorado. Each plan offers a generous employer match between 10% – 21%. For more information, visit:https://hr.colostate.edu/current-employees/benefits/afap/retirement/.

Top Public Research University

Colorado State University is one of the nation’s top public research universities and an institution on the rise. In the last decade, CSU has:

• Produced record enrollment

• Built on all-time highs in student diversity and student success

• Delivered groundbreaking research driven by a highly productive faculty

• Revitalized campus through a transformational building campaign

• Shaped an unrivaled learning environment where nine of 10 recent graduates say they would choose CSU again and rate their education as excellent

Campus Culture and Principles of Community

Colorado State University has a campus culture that is driven by a desire always to do better and a vision to be the best place to learn, work, and discover. Our Principles of Community – Inclusion, Integrity, Respect, Service, and Social Justice – reflect our core values and support CSU’s mission and vision of access, research, teaching, service, and engagement. Each member of our community has a responsibility to uphold these principles when engaging with one another and acting on behalf of the University. For more information visit:https://hr.colostate.edu/prospective-employees/our-people/.

Tobacco and Smoke-Free

Colorado State University is a tobacco and smoke-free campus. For the health of our university community, the use of smoking, vaping or tobacco products is prohibited on CSU grounds or in buildings.

Live in Fort Collins

Fort Collins has been home to CSU since the University’s inception in 1870. It is a vibrant, friendly city of 161,000 tucked against the foothills of the Rocky Mountains in Northern Colorado, 60 miles from Denver. The strong local economy is noted particularly for a broad range of outdoor activities and a thriving arts and entertainment industry.

Position Summary

The Insurance Specialist provides excellent customer service and guidance to all CSU students in navigating their health insurance needs, regardless of their enrollment in the CSU Student Health Insurance Plan ( SHIP ) or an outside insurance plan. Staff members are responsible for SHIP , the RamCare Program, the RamCare Grant Program, and CSU’s Health Insurance Requirement.

Specific duties related to CSU’s Health Insurance requirement are: Insurance Specialists regularly speak with students and parents to answer questions related to the CSU health insurance requirement, are experts in navigating student categories that are required to provide proof of insurance to CSU and can discern what type of plans will and will not meet the insurance requirement. Insurance Specialists are also experts in understanding and explaining to students which student categories and enrollment levels are eligible to enroll in SHIP and RamCare. Staff members work with and use the third-party waiver company to verify eligibility, enrollment, and waivers while using multiple CSU systems (Aires Web, Banner, PyraMed). Staff members are expected to use research, resources, and seek advice from the supervisor to make decisions in their daily work.

Specific duties related to SHIP and RamCare/RamCare Grant are: Managing enrollment and cancelations, billing premiums, posting, and paying claims in the electronic health record ( EHR ) system, auditing, managing spreadsheets, working with the office of financial aid, and providing customer service. Insurance Specialists regularly process claims using the CSU Health Network’s ( CSUHN ) electronic health record system (PyraMed) and an Access database, for services provided at CSUHN for both the Student Health plan and RamCare. Staff are responsible to understand the laws and documentation required for enrolling qualified life events ( QLE ) under SHIP . Staff may work directly with the insurance carrier to resolve issues. Insurance Specialists monitor student withdrawals and adjust enrollment as appropriate. This role may also run and record monthly reports as it relates to claims payments at the CSU Health Network

Specific duties related to international student insurance enrollment and waivers are: International degree seeking students and those enrolled in the CSU PLACE program under international programs, are required to provide proof of insurance or be enrolled in the CSU student health plan. Insurance Specialists assist international students with their insurance waivers and are responsible for completion of the international waiver process by evaluating and working with the supervisor to make decisions regarding comparability of various group and individual policies against the insurance requirements established by CSU , the Board of Governors, and Federal visa requirements. The PLACE program adds a monthly option to the CSU SHIP that makes the complexity of determining eligibility, claims payment, and tracking, more difficult.

Waiver, enrollment, and payment processing often require follow up with other departments within CSUHN as well as with outside vendors to ensure accurate waivers, enrollment, and payment. Staff in this position will be trained to understand when and how to reach other areas. All staff members are trained and able to back up at least one other staff member in the department to ensure continuity of workflow.

This position is a 12-month, full-time position working 40 hours/week, Monday-Friday and reports directly to the Student Insurance Manager.

Required Job Qualifications

Education

• High School Diploma or GED

Experience

• Two years of health insurance billing experience in a medical provider or health insurance setting, which must include at least one year of direct customer service

Preferred Job Qualifications

Education

• Associate or Bachelor’s degree in related field

Experience

• One or more years of experience processing health insurance claims

Knowledge, Skills, Abilities and Other Characteristics

• Personal computer and office software proficiency

• Use of an Electronic Health Record ( EHR )

• Strong interpersonal, listening, verbal and written communication skills

• Effective skills in teamwork and conflict management

• Strong organization and follow-through

• Mathematical and analytical skills demonstrating work that is detail oriented and with high accuracy

• Knowledge of medical terminology/physiology and anatomy

• Knowledge of HIPAA

• Ability to analyze policies, programs, and initiatives to make recommendations for quality improvement

• A personal or professional commitment to diversity, equity, and inclusion through active planning and purposeful effort

Diversity Statement

Reflecting departmental and institutional values, candidates are expected to have the ability to advance the Department’s commitment to diversity and inclusion.

Essential Duties

Job Duty CategoryClaims Payment and Processing for SHIP, RamCare and RamCare Grant

Duty/Responsibility

• Research medical records of SHIP or RamCare insured students, including CPT and ICD -9 medical coding, diagnosis codes, physician notes and SHIP or RamCare program parameters in evaluating if charges for medical care obtained at the CSU Health Network ( CSUHN ) are payable under the self-funded portion of the plan.

• Enter payable charges into a separate database (Access) and process through the EHR (electronic health record), PyraMed. If determined to be non-payable, send charges to the student account.

• Process payments in the pharmacy system for both RamCare and SHIP .

• Balance daily reports between PyraMed and Access systems and provide to the Health Network accounting department for their daily reconciliation.

• Other duties as assigned.

Percentage Of Time35%

Job Duty CategoryWaiver Process

Duty/Responsibility

• Under the direction and support of the supervisor, manage the institutional requirement for all full-time students and all international students to carry health insurance by providing customer service, analyzing the external waiver system and provide additional outreach to students whose waivers are failing.

• Review plans submitted for waiver for international students and make determinations.

• Work with waiver vendor to assist domestic students through the online waiver process.

• Assist with and coordinate appeals for students who did not complete the waiver process in the waiver period. This involves the ability to professionally interact with the student, parent, waiver company and/or insurance company to make sure all needed information is obtained, verify active and compliant coverage, and hand off to the supervisor for final review and communication with the student and parent.

• Other duties as assigned.

Percentage Of Time25%

Job Duty CategoryEligibility and Customer Service

Duty/Responsibility

• With support, determine individual insurance needs and whether or not each student meets the eligibility requirements for enrollment in the plan; utilize Pyramed, Aries, Banner, and the third-party waiver system for information.

• Provide customer service for the insurance program by addressing walk-in traffic, phone calls or emails.

• Know and follow the legal requirements for appropriate information release under HIPAA and FERPA .

• Follow appropriate documented in-house procedures.

• Other duties as assigned.

Percentage Of Time20%

Job Duty CategoryEnrollment, Cancellations and Billing

Duty/Responsibility

• With support maintain and update enrollment rosters of insured students after validating that required eligibility standards have been met; this can involve research and entry into multiple University systems and interactions with other campus departments including international programs, the graduate program, and the registrar’s office.

• Assist students in enrollment or cancellation of policy as appropriate.

• Conduct manual billing of insurance premiums and other applicable fees as necessary.

• Receive notifications of changes to student status and determine how this change affects their insurance eligibility.

• Participate in regular enrollment audits.

• Other duties as assigned.

Percentage Of Time20%

Application Details

Special Instructions to Applicants

CSU is committed to full inclusion of qualified individuals. Applicants needing assistance to submit application materials may contact Tammy Roehrich at Tammy.Roehrich@colostate.edu.

Complete applications must include:

• Cover letter addressing Required Job Qualifications, Preferred Job Qualifications and Essential Job Duties

• Resume

For full consideration, complete applications must be received by 11:59 pm Mountain Time on Sunday, January 5, 2025.

References will not be contacted without prior notification of candidates.

Applicants may redact information from their application materials that identifies their age, date of birth, or dates of attendance at or graduation from an educational institution.

Application materials will be held in confidence by the Search Committee through semi-finalist interviews. Confidentiality of application materials detaches at the point where a candidate accepts participation in a finalist interview. At that time, redacted application materials are shared with campus stakeholders when invited to participate and give feedback to the Search Committee.

Conditions of EmploymentPre-employment Criminal Background Check (required for new hires), Special Requirements/Other - Health Network follows CDC guidelines for Employee Health in a healthcare setting, including proof of vaccinations. Employees must show proof of compliance/willingness to comply by start date.

Search ContactTammy Roehrich, tammy.roehrich@colostate.edu

EEO Statement

Colorado State University is committed to providing an environment that is free from discrimination and harassment based on race, age, creed, color, religion, national origin or ancestry, sex, gender, disability, veteran status, genetic information, sexual orientation, gender identity/expression, or pregnancy in its employment, programs, services and activities, and admissions, and, in certain circumstances, marriage to a co-worker. The University will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. Colorado State University is an equal opportunity and equal access institution and affirmative action employer fully committed to achieving a diverse workforce and complies with all Federal and Colorado State laws, regulations, and executive orders regarding non-discrimination and affirmative action. TheOffice of Equal Opportunity (https://oeo.colostate.edu/) is located in 101 Student Services.

The Title IX Coordinator is the Director of the Office of Title IX Programs and Gender Equity, 123 Student Services Building, Fort Collins, CO 80523-0160, (970) 491-1715,titleix@colostate.edu.

The Section 504 and ADA Coordinator is the Director of the Office of Equal Opportunity, 101 Student Services Building, Fort Collins, CO 80523-0160, (970) 491-5836,oeo@colostate.edu.

The Coordinator for any other forms of misconduct prohibited by the University’s Policy on Discrimination and Harassment is the Vice President for Equity, Equal Opportunity and Title IX, 101 Student Services Building, Fort Collins, Co. 80523-0160, (970) 491-5836,oeo@colostate.edu.

Any person may report sex discrimination under Title IX to theOffice of Civil Rights, Department of Education (https://www2.ed.gov/about/offices/list/ocr/docs/howto.html) .

Background Check Policy Statement

Colorado State University strives to provide a safe study, work, and living environment for its faculty, staff, volunteers and students. To support this environment and comply with applicable laws and regulations, CSU conducts background checks for the finalist before a final offer. The type of background check conducted varies by position and can include, but is not limited to, criminal history, sex offender registry, motor vehicle history, financial history, and/or education verification. Background checks will also be conducted when required by law or contract and when, in the discretion of the University, it is reasonable and prudent to do so.

References Requested

References Requested

Minimum Requested3

Maximum Requested3

Supplemental Questions

Required fields are indicated with an asterisk (*).

• • Do you have a High School Diploma or GED?

• Yes

• No

• • Do you have two years of health insurance billing experience in a medical provider or health insurance setting, which includes at least one year of direct customer service?

• Yes

• No

Applicant Documents

Required Documents

• Cover Letter

• Resume

Optional Documents