Medical Billing & Coding Specialist, Daytona Beach Campus

About the role

The Opportunity: Embry-Riddle Aeronautical University (ERAU) is seeking a Medical Billing and Coding Specialist within the Health Services Department at our Daytona Beach Campus. This position is in alignment with the mission, vision, and strategic priorities of Embry-Riddle Aeronautical University (ERAU) and the Division of Student Affairs, providing high-quality, student-centered service that supports student well-being, persistence, and success.

Responsibilities

• Serve as the primary liaison for students, Student Services, and the University's health insurance provider regarding student health insurance enrollment and coverage.
• Coordinate the addition and removal of domestic and international students who elect to enroll in or waive the University-sponsored health insurance plan.
• Manage health insurance enrollment changes for students participating in internships, co-ops, and other approved academic experiences.
• Provide students with proof of insurance documentation and other insurance-related records as requested.
• Maintain and update Health Services insurance website content to ensure accurate and timely information.
• Aid students in resolving discrepancies related to health insurance charges on student accounts and billing statements.
• Respond to student, parent, and campus partner inquiries regarding health insurance coverage, enrollment, waivers, claims, and billing.
• Communicate enrollment, waiver, and coverage changes accurately and timely to the University's health insurance provider.
• Provide exceptional customer service through phone, email, and in-person interactions while supporting students' access to healthcare services.
• Enter and process patient encounter, coding, and billing information in applicable billing and electronic medical record systems in a timely and accurate manner.
• Submit insurance claims and monitor claim status to ensure appropriate reimbursement and timely resolution of outstanding balances.
• Reconcile incoming payments, Explanation of Benefits (EOBs), and remittance documents to ensure accurate account records.
• Ensure checks, EOBs, and related billing documentation are accurately scanned and maintained within the electronic medical record system.
• Cooky processing and deposit of insurance payments, checks, and electronic reimbursements in accordance with university procedures.
• Reconcile third-party vendor invoices and insurance-related billing statements on a monthly basis.
• Review and reconcile health insurance provider invoices and coordinate payment processing as appropriate.
• Generate and provide billing, reimbursement, and revenue reports to Health Services leadership as requested.
• Maintain accurate financial records and ensure compliance with university, insurance, and regulatory requirements related to medical billing and coding.
• Review and resolve billing discrepancies, unpaid claims, denied claims, and reimbursement issues to ensure accurate and timely payment for services rendered.
• Cooky claim corrections, resubmissions, and appeals with insurance providers as necessary to maximize reimbursement and maintain compliance with billing requirements.
• Educate and assist students in navigating the University's health insurance provider website, including accessing digital ID cards, reviewing benefits, locating in-network providers, and understanding coverage options.
• Guide students through insurance-related processes, including filing claims, submitting required documentation, and enrolling in, modifying, or waiving coverage when applicable.
• Assist students in understanding health insurance benefits and coverage, including co-pays, deductibles, coinsurance (80/20 coverage), out-of-pocket costs, and the claims and appeals process.
• Serve as a knowledgeable resource for students, families, and campus partners regarding health insurance policies, benefits, procedures, and requirements.
• Provide guidance and support to students experiencing insurance-related concerns and assist in resolving coverage, eligibility, and benefit issues.
• Respond to student, parent, and campus partner inquiries regarding health insurance enrollment, waivers, claims, billing, and coverage in a timely and professional manner.
• Promote awareness of available health insurance resources and services to support student access to healthcare and overall well-being.
• Serve on University and division committees as deemed appropriate.
• Essential personnel in response to campus crises, as designated by the Dean of Students.

Qualifications

• Required Education and Qualifications: Associate's degree or completion of program of 18+ months after high school. Required Licenses And Certificates: Certified Professional Coder (CPC), Certified Coding Associate (CCA), Certified Billing and Coding Specialist (CBCS), or similar certification. OR Associate degree in Medical Billing and Coding, Health Information Management, Healthcare Administration, Business Administration, or a related field; or an equivalent combination of education and relevant experience.
• Required Skills, Knowledge, Abilities: Knowledge of medical terminology, CPT, ICD-10, and HCPCS coding systems. Experience working with electronic medical record (EMR) and medical billing systems. Demonstrated knowledge of health insurance plans, claims processing, reimbursement procedures, and billing regulations. Strong customer service, communication, organizational, and problem-solving skills.