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Posting Detail Information

Working TitleInsurance Denials Specialist

Position LocationFort Collins, CO

Work LocationPosition qualifies for hybrid/in-office work

Research Professional PositionNo

Posting Number202500843AP

Position TypeAdmin Professional/ Research Professional

Classification TitleTechnical/Support II

Number of Vacancies

Work Hours/Week40

Proposed Annual Salary Range$50,000 – $55,000; 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, 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) on06/29/2025

Description of Work Unit

Billing and Coding

The Billing and Coding department at the CSU Health Network provides the service of accurately coding and billing clinic charges to commercial insurance companies. The department acts as the liaison between student/parents and their insurance company to decipher contracting status and claim payment disputes. Our department follows the status of payments to ensure insurance companies are paying in a timely and accurate manner. The Billing and Coding department provides services between the hours of 8:00 am – 5:00 pm Monday-Friday, providing attractive work schedules for staff.

CSU Health Network

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/

Division of Student Affairs

The Division of Student Affairs fosters a welcoming and sustainable campus community that supports students and staff holistically. We collaborate across the University to inspire and empower students to be active learners inside and outside the classroom, successful graduates, and engaged global citizens. We support student success through an array of services and resources including housing, dining, recreation, student government, student organizations, as well as legal, career, health, well-being, belonging, and crisis services. The Division employs 900 career staff, 2,000 student and hourly staff, and manages a budget of over $250 million.

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

+ 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 Denials Specialist will provide excellent customer service and guidance to all CSU students in navigating their health insurance needs, regardless of their enrollment in the CSU insurance program or an outside insurance plan.

This position will be responsible for working with insurances and staff to determine correct course of action when a claim is denied. It will also be necessary to appeal denials and train staff with registration or coding denials. They will also be responsible for working with insurance companies when refunds are requested to determine next steps. In addition, this position will ensure Accounts Receivables (AR) are reviewed to ensure claims are paid in a timely manner and no loss of revenue due to timely filing issues.

At this time, the Insurance Denials Specialist works a hybrid onsite/remote schedule from 8:00 AM – 5:00 PM, Monday – Friday, and reports directly to the Billing and Coding Manager.

Required Job Qualifications

Education

+ High School Diploma (or GED )

Experience

+ Three years of experience working insurance claims denials and posting payments in a medical office billing environment, which may have included a clinic laboratory

+ Experience with Electronic Health Record ( EHR ) systems and billing and insurance regulations

Preferred Job Qualifications

Education

+ Associates degree in Health Information Management

Experience

+ Certified Biller and/or Certified Coder, or equivalent experience

+ Five years of experience working insurance claims denials and posting payments in a medical office billing environment, which may have included a clinic laboratory

+ Three years experience with laboratory billing/denials

+ Coding background in medical office billing, outpatient mental health, and physical therapy desired

Knowledge, Skills, Abilities and Other Characteristics

+ Knowledge of applying insurance contracts, including provider credentialing

+ Proficiency with Microsoft Word and Excel tracking data in spreadsheets

+ Strong listening, interpersonal, verbal and written communication skills

+ Ability to prioritize multiple workflows and accomplish work accurately and timely

+ Ability to maintain confidentiality of patient information in accordance with HIPAA ; CSU Health Network policies; Colorado State University; state and federal regulations

+ Strong attention to detail and organizational skills

+ Strong decision making and problem-solving skills

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

Essential Duties

Job Duty CategoryExplanation of Benefits (EOB) Denial Review

Duty/Responsibility

+ Evaluate insurance EOB to determine correct payment based on students insurance plan.

+ Evaluate insurance EOB to determine payment is based on our contracts with the insurance.

+ Evaluate insurance EOB to determine if duplicate payment from insurance.

+ Evaluate insurance EOB to determine if payment is for one of our patients.

+ Evaluate insurance EOB for any insurance “take-backs” and determine which account payments and adjustment need to be removed from one patient account and applied to another patient account.

+ Follow up with insurance to discuss why a “take-back” occurred and provide information to Medical Billing & Payment Posting Specialist who works denials to correct issue.

+ Apply adjustment/calculation/claims payments from insurance companies to student EHR account.

+ Enter reason codes to explain payment /non payment details.

+ Evaluate any remaining balances and determine if balances due are to be applied to supplemental plans or applied to the student account.

+ Review EOBs that show claims are denied and determine if they are correct based on the students medical insurance plan.

+ Work with the Medical Billing & Payment Posting Specialist to determine best next step for contesting denials.

+ Provide information to students, parents, and attorneys regarding billing and charges with ensuring correct releases are in place.

+ Performs other duties as requested by Manager

Percentage Of Time35%

Job Duty CategoryAppeals

Duty/Responsibility

+ Provide excellent customer service to patients, parents, insurance and staff, while following HIPPA guidelines when discussing payments/adjustments/denials.

+ Contact insurance companies if claims are paid inaccurately and determine if claim can be reprocessed with additional information.

+ Fill out all necessary forms either created in by Medical Billing & Payment Posting Specialist or provided by the insurance company for necessary claims denial appeals.

+ Evaluate student insurance policy eligibility by utilizing multiple web pages (Medicaid, all contracted insurance web pages).

+ Work aging to ensure claims are paid within 61 days and contact insurance to status of claim is their system.

+ Performs other duties as requested by Manager

Percentage Of Time25%

Job Duty CategoryMaintaining Accounts Receivables (AR)

Duty/Responsibility

+ Monitor insurance company payments and ensure that they are received and posted correctly to patient accounts.

+ Handles various tasks related to submitting claims, managing reimbursements, and collecting payments from insurances

+ Correct errors made by payee or identified through the AR work place

+ Follow up with staff and appropriate parties.

+ Ensure claims are no older than 90 days within the AR workplace

+ Performs other duties as requested by Manager

Percentage Of Time20%

Job Duty CategoryApply Coding

Duty/Responsibility

+ Assist with coding as related to payments.

+ Access the EHR , billing system, or other CSU systems in order to complete postings.

+ Verify medical insurance eligibilities to determine accurate claim submission to prevent denials utilizing Availity (our contracted clearing house which submits claims to insurance companies electronically) and other insurance companies web pages. It may be necessary to call the insurance company to get accurate information.

+ Post charge to the students account in EHR . User must review the medical record to ensure encounter has been finalized by the provider, review coding to ensure there is a diagnosis code, procedure code with the correct amount of units applied, and then determine if the charge will go to the students self-pay account, or determine which health plan the charges will be billed to.

+ Review and post charges prior to submission to the Availity.

+ Once claims have been submitted, staff members are required to evaluate Errors in Availity to determine any additional charging or insurance policy errors prior to claims being submitted electronically.

+ Review encounters prior to posting to ensure accurate and legal billing.

+ Performs other duties as requested by Manager

Percentage Of Time10%

Job Duty CategoryCustomer Service

Duty/Responsibility

+ Provide excellent customer service and teaching to patients and staff as indicated regarding insurance and coding procedures.

+ Assist students with understanding the insurance billing process and the status of their claims while using multiple systems (PyraMed, Banner, Arise Web).

+ Contact from students, parents, and insurance may be by phone, e-mail, or onsite. Ensure you are reviewing the EHR for appropriate releases in order to follow HIPPA regulations.

+ Understand all departments within CSU Health Network to ensure you are referring students questions to other departments when they do not pertain to billing.

+ Understand how SHIP , RamCare, and RamCare Grant interacts with CSU Health Network and the student.

+ Assess eligibilities to ensure there is an understanding of the students policy prior to coming into the clinic.

+ Review billing email to respond to student/parent billing questions.

+ Work tasks within EHR to answer provider staff and co-workers questions.

+ Performs other duties as requested by Manager.

Percentage Of Time5%

Job Duty CategoryRefunds/Take Backs/Reception Registration Insurance Training

Duty/Responsibility

Refunds/Take Backs:

+ Files and maintains refund back copies.

+ Contact insurance to verify reason for refund request.

+ Request reprocessing or submit and appeal if there is an error on the request.

+ Contacts insurance to request take back instead of refund

+ Documents EHR with all information about the takeback.

Training:

+ Document known registration errors to prepare for trainings.

+ Work with individuals when there are consistent errors.

+ Create training manuals and update to ensure consistency.

+ Work with Registration manager to schedule trainings with their staff.

+ Follow up with manager on a monthly basis on errors

+ Performs other duties as requested by Manager

Percentage Of Time5%

Application Details

Special Instructions to Applicants

Complete applications must include:

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

+ Resume

+ Contact information for three professional references. References will not be contacted without prior notification of candidates.

The posting is open until filled. For full consideration, complete applications must be received by 11:59pm Mountain Time on Sunday, June 29, 2025.

Note that 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.

CSU is committed to full inclusion of qualified individuals. Applicants needing assistance to submit application materials may contact Tammy Roehrich at [email protected].

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, [email protected]

EEO

Colorado State University ( CSU ) provides equal employment opportunities to all applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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 three years of experience working insurance claims denials and posting payments in a medical office billing environment, which may have included a clinic laboratory?

+ Yes

+ No

+ * Do you have experience with Electronic Health Record (EHR) systems and billing and insurance regulations?

+ Yes

+ No

Applicant Documents

Required Documents

+ Cover Letter

+ Resume

Optional Documents