- Princeton University
- New Jersey, United States
- Salary Not specified
- Posted Date
- Dec 23, 2022
- Position Type
- Faculty Positions, Business & Management, Business Administration
- Employment Level
- Employment Type
- Full Time
Reporting to the Manager, Student Health Plan, and working within the Student Health Plan Office at University Health Services, the Insurance Specialist independently supports the day-to-day operations of Princeton University's Student Health Plan, optional dental and vision plans, and related policies. They provide superior customer service to enrollees in these plans, comprised of over 6,000 undergraduate students, graduate students, and dependents. They act as a resource regarding all plans and provide complex and detailed customer service to all plan members.
Client Service and Support
day-to-day administration of the Student Health Plan in compliance
with benefit plan documents, federal and state regulatory
requirements, and established policies and procedures.
Provides detailed and
complex written and verbal communications on insurance-related
policies and procedures.
Conducts daily in-person
Consults with and
advises a diverse student population, parents, staff, etc., on
benefit eligibility, plan provisions, claims, and other benefits
related information. Acts as liaison with students, staff,
insurance carriers, providers, etc., to expedite and resolve the
prompt resolution of various benefit issues. Responds to student
questions, provides, explains, or clarifies benefits information.
Determines when specific benefit issues exceed the scope of
responsibility and refers to Manager for prompt attention and
Enters daily referrals
for off-campus specialist care. Investigates, resolves, and
enrollment processes to include benefit plan eligibility, tracking
enrollment and completion data. Periodically interacts with Deans
in the Graduate School, Registrar's Office, Dean of the College
office, and other academic departments to ensure an overall smooth
process and effective integration of processes and procedures.
Interfaces directly and
regularly with a diverse student and staff population, vendors,
healthcare and insurance providers, etc., concerning policies,
procedures, initiation and/or termination of benefits, and related
enrollment issues, using current and changing knowledge of
proprietary vendor systems to assist student participants.
activities associated with the benefits enrollment process for both
new students and the annual benefits enrollment period. Prepares
benefit enrollment materials, provides assistance to Manager in the
development of benefit communications, monitors the receipt of
student benefit elections and performs necessary follow-up.
to policy and claims inquiries or routes them to vendor management.
Applies independent judgment and discretion to authorize and
prioritize work scheduling. Deals with highly complex, confidential
and sensitive information during the course of daily work.
Establishes and maintains necessary files to ensure accuracy and
consistency of process. Makes independent decisions regarding daily
operations as needed.
and processes claim reimbursements/payments in accordance with
established policies and procedures. Investigates, resolves, and
reprocesses referrals and benefit claims in compliance with
established processes and procedures to ensure a timely and
Sets up and attends
student benefits fairs and orientations. Prepares and delivers
Actively participates in
the continuous assessment and improvement of internal processes and
the integration of related information and reporting systems to
ensure the effective and efficient operations related to areas of
abreast of current and changing rules, regulations, procedures, and
other benefits-related issues through attendance at educational and
training sessions. Integrates and applies knowledge into daily plan
Ensures the ongoing
accuracy of all student benefits records; e.g., enrollment data,
student status, and related census information, through the
development and maintenance of multiple internal and vendor
databases. Supports enrollment management through the collection
and electronic entry/upload of required information through MyUHS
website and authentication of required documentation.
all forms/listservs/databases, and other cyclical
events/activities; edits/updates PowerPoint, Excel, and Word files;
assembles information and correspondence.
As a first-line contact
for students, staff, etc., represents a positive image of the
department and its services at all times.
Promotes the department
and benefit-related services offered to its diverse student
population through the preparation of various benefit
communications, ongoing maintenance and updating of department
website, editing for print media and website content, preparation
of event calendars, etc.
administrative activities to contribute to the overall efficiency
of department operations.
Tracks and categorizes
student benefit costs to identify variances and support the
development of annual benefit cost projections.
accurate/compliant preparation and reconciliation of the student
medical, prescription, dental, and vision plans.
reimbursements, vouchers, and other financial procedures related to
SHP and Athletic Activity Fund. Reconciles financial assistance
applications and spreadsheets for submittal to the Dean of the
Graduate School medical emergencies fund.
• Bachelor's degree.
• Strong understanding of benefit plans and insurance terminology.
• At least 3 years of benefits administration experience.
• Knowledgeable about healthcare market and related insurance models.
• Experienced in vendor management and operation of service providers.
• Familiar with financial review of activity, reporting, and data reconciliations.
• Excellent verbal, written communication skills and project management skills
• Strong analytical and judgement skills.
• High level of integrity, professionalism with balanced approach to problem solving.
• Highly organized with ability to manage multiple cases and activities.
• Knowledgeable in principles and methodologies (e.g., Plan-Do-Study-Act, Root Cause Analysis, measurement, data collection, and analysis) needed to support and lead Quality Improvement projects and activities and/or willing to attend UHS-based Quality Improvement basic training within first 6-months of hire.
• Medicat experience preferred.
• Evidence of management of at least 1 project requiring new installation of benefits and writing of related communications.
• Familiarity with total work systems (such as the Institute for Healthcare Improvement, Accreditation Association for Ambulatory Health Care, and Baldrige National Quality Program); and reviewing and analyzing data. Princeton University is an Equal Opportunity/Affirmative Action Employer and all qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity or expression, national origin, disability status, protected veteran status, or any other characteristic protected by law. EEO IS THE LAW
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