Job no: 514628
Work type: Staff Full Time
Location: UMass Amherst
Department: Operations
Union: USA/MTA
Categories: Health & Medical Services, Administrative/Office Support

About UMass Amherst

UMass Amherst, the Commonwealth's flagship campus, is a nationally ranked public research university offering a full range of undergraduate, graduate and professional degrees. The University sits on nearly 1,450-acres in the scenic Pioneer Valley of Western Massachusetts, and offers a rich cultural environment in a bucolic setting close to major urban centers. In addition, the University is part of the Five Colleges (including Amherst College, Hampshire College, Mount Holyoke College, and Smith College), which adds to the intellectual energy of the region.

Job Summary

Enrolls students into health plans, ensures waiver compliance, creates medical records charts, and answers questions regarding insurance health plans. Works under the direct supervision of the Patient Accounts Manager.

Essential Functions

• Registers University Health Services (UHS) patients into Patient Management System; obtaining demographic information along with insurance information. Ensures fields are complete.
• Creates medical records for new UHS patients, generates number, labels and appropriate forms prior to appointments.
• Enrolls students into appropriate UHS student health benefit plans using the Patient Management System. Ensure students meet the eligibility requirement for the plan.
• Discusses benefits of the health plans, gives necessary brochure information. Speaks to parents and students regarding insurance and waiver polices and deadlines.
• Works closely with the school sponsored insurance company on enrollment, health plan information, claim problems and other issues that arise on a daily basis.
• Collects cash, checks, credit cards and UCard payments for medical payments and co-payments. Ensures accuracy in payment collection and separation of accounts. Monitors cash logs and oversees security of the safe.
• Acts as liaison with on-campus offices, such as Bursar’s office, Financial Aid, Registrar’s office, Grad Assistantship office, and International Programs office, regarding UHS insurance billing issues, registration and in purchasing health plans.
• Monitors activity on the school sponsored on-line system. Assists students with website access problems and those who need to do paper waivers. Contacts the insurance company to resolve any on-line waiver site problems. Reviews questionable data received from the on-line waiver system and works with the UHS systems department to correct these issues.
• Sends weekly charges and credits to the Bursar’s office to adjust students’ accounts for health plan enrollments and health plan cancellations.
• Assist students with their insurance coverage when there are medical and administrative withdrawals, i.e. determine eligibility.
• Process qualified life status events of students who have lost coverage. Enroll new members or dependents on the health benefit plan.
• Performs follow-up corrective activities resulting from audit findings on the on-line waiver process using information provided by the school sponsored insurance company. Recharges insurance accordingly.
• Cross train with clinic receptionist to arrive patients and schedule follow-up appointments using the Scheduling Module.
• Provides coverage for resource fairs and orientations; giving details of health plans, UHS services, on-line waivers and student immunization compliance module (ICM).
• Investigates and responds to questions from UHS clinic staff and medical providers regarding the many different coverage plans and specific health benefits. Accesses insurance company websites to research and verify accurate benefit information. (Required to maintain valid and current access to insurance websites.)
• Supports and promotes excellence in customer relations. Front line customer service. Promotes a harmonious work environment by interacting respectfully with co-workers, providers and patients. Participates in necessary training and serves on UHS committees as assigned.
• Provides administrative support to Student Health Insurance Plan Manager.
• Works on special projects as assigned by Student Health Insurance Plan Manager.
• Works on reconciliations by researching discrepancies determined by Student Health Insurance Plan Manager.
• Performs other duties as assigned.

Minimum Qualifications (Knowledge, Skills, Abilities, Education, Experience, Certifications, Licensure)

• High School graduate or equivalent required.
• Prior experience in medical setting and dealing with the public.
• Prior experience in insurance or insurance administration.
• General knowledge of health insurance plans and ability to explain health insurance benefits.
• Knowledge of standard office practices and procedures, including a good working knowledge of spelling, punctuation and grammar.
• Strong computer skills.
• Clerical and office skills, good typing and excellent telephone skills, use of office equipment.
• Ability to perform data entry functions and numerical computations.
• Ability to understand and communicate detailed and complex health plan information.
• Ability to communicate with colleagues, the public and other UHS staff.
• Ability to handle front line customer service complaints.
• Knowledge of medical terminology preferred.

Physical Demands/Working Conditions

• Typical Health Clinic Office Environment Activity.

Additional Details

Qualifications Acquired On Job

• Detailed knowledge of health plan offered by UHS.
• Understanding the need for confidentiality as required by UHS policy.
• Ability to use and understand aspects of the Patient Management System.
• Knowledge of UHS financial policies and procedures.
• Knowledge of higher education database application, i.e., SPIRE or BANNER.

Work Schedule

• Monday – Friday, 8:30 am – 5:00 pm (37.5 hours per week).

Salary Information

Grade 11

Special Instructions to Applicants

Along with the application, please submit a resume, cover letter, and contact information for three (3) professional references. Search will remain open until filled.

UMass Amherst is committed to a policy of equal opportunity without regard to race, color, religion, gender, gender identity or expression, age, sexual orientation, national origin, ancestry, disability, military status, or genetic information in employment, admission to and participation in academic programs, activities, and services, and the selection of vendors who provide services or products to the University. To fulfill that policy, UMass Amherst is further committed to a program of affirmative action to eliminate or mitigate artificial barriers and to increase opportunities for the recruitment and advancement of qualified minorities, women, persons with disabilities, and covered veterans. It is the policy of the UMass Amherst to comply with the applicable federal and state statutes, rules, and regulations concerning equal opportunity and affirmative action.

Advertised: Jun 16 2022 Eastern Daylight Time
Applications close: