Insurance Specialist

Duke University:

Duke University was created in 1924 through an indenture of trust by James Buchanan Duke. Today, Duke is regarded as one of America's leading research universities. Located in Durham, North Carolina, Duke is positioned in the heart of the Research Triangle, which is ranked annually as one of the best places in the country to work and live. Duke has more than 15,000 students who study and conduct research in its 10 undergraduate, graduate and professional schools. With about 40,000 employees, Duke is the third largest private employer in North Carolina, and it now has international programs in more than 150 countries.

Positional Summary

Perform a variety of duties associated with assisting with the Duke Student Medical and Dental Insurance Plans, which include providing customer service and communication through email and phones calls. Assisting in waiver verification and reconciliation processes. Perform duties related to patient specialist referrals and pre-authorizations. Registering patients for services in the Student Health clinic, including interviewing student patients to obtain and process patient data, verifying insurance information, collecting payments, and scheduling appointments.

Key Position Duties

Student Health Insurance Support - 30% of Effort

• Provide comprehensive customer service and communication to Duke students, parents, and university departments regarding the Student Health Insurance and Dental Insurance Plan enrollment process.
• Assist in administering the Duke Student Health Insurance and Dental Plans, including enrollment and eligibility verification.
• Support insurance waiver verification processes and assist with related accounting functions.
• Collaborate with campus partners, departments, and special student programs to ensure students meet health insurance requirements and are properly enrolled.
• Respond to student, parent, and departmental questions, concerns, and inquiries related to insurance enrollment, benefits, deadlines, and coverage and maintain documentation in accordance with established procedures.
• Participate in orientations, outreach activities, and educational initiatives to promote understanding of student health insurance obligations and available resources.

Specialty Referral Coordination- 30% of Effort

• Assist with the full referral process for external specialty care, ensuring accurate documentation and seamless patient transitions.
• Coordinate and schedule specialty appointments while maintaining communication between patients and specialty clinics.
• Obtain required prior authorizations to support timely and efficient continuity of care.
• Provide clear and accurate previsit financial estimates for specialty procedures.
• Communicate ongoing updates regarding insurance benefits, referral requirements, and policy changes to clinicians and staff to ensure accurate and consistent service delivery.
• Maintain uptodate communication with clinicians and staff regarding changes in insurance benefits and referral procedures.
• Assist in training new and existing staff by providing ongoing guidance, support, and informational resources to ensure consistent understanding of insurance processes and procedures.

Patient Registration and Support- 35% of Effort

• Assist in staffing the Student Health front desk, serving as a first point of contact and support for Duke students seeking services and guidance within the Student Health Clinic.
• Register patients for services in the Student Health Clinic and conduct intake interviews to collect and verify patient data.
• Confirm insurance coverage and benefits prior to appointments to support accurate billing and care coordination.
• Schedule patient appointments and maintain uptodate records within the Duke Health Medical Record system.
• Assist clinic operations by supporting administrative and documentation workflows.
• Assist students with insurance claim rejections and denials.
• Explain outstanding bills and insurance policies.
• Communicate with insurance carriers regarding clinical information requested to resolve issues to coverage and payment.
• Assist with the scanning, organizing, and processing of medical records by preparing documents, performing highquality digitization, verifying accuracy, and ensuring all patient information is handled in compliance with HIPAA and organizational standards.

Other- 5% of Effort

• Perform related duties as assigned or required to meet departmental, Division and University goals and objectives, as assigned by their Supervisor, Director, or respective designees.

The intent of this job description is to provide a representative outline of the type of responsibilities that will be required of positions given this title and shall not be construed as all-encompassing or as a declaration of all specific duties and responsibilities of this position. Employees may be directed to perform job-related tasks other than those specifically presented in this description.

Anticipated Payrate

Duke University provides an annual base salary range for this position as USD $18/hr to USD $25.54/hr. Duke University considers factors such as (but not limited to) scope and responsibilities of the position; candidate's work experience, education/training, and key skills; internal peer equity; as well as market and organizational considerations when extending an offer.

Your total compensation goes beyond the dollars on your pay check. Duke provides comprehensive and competitive medical and dental care programs, generous retirement benefits, and a wide array of family-friendly and cultural programs to eligible team members. Learn more at: https://hr.duke.edu/benefits/

Minimum Qualifications:

Minimum Education

• Work requires knowledge of basic mathematical, research, and communication principles typically acquired through two years of postsecondary education.

Minimum Experience

• Work generally requires two years of clerical or research experience to acquire skills in administrative or project research responsibilities as well as accepted office organization, communications and research practices. A bachelor's degree may be substituted for the required education and experience, or an equivalent combination of relevant education and/or experience may be considered. OR AN EQUIVALENT COMBINATION OF RELEVANT EDUCATION AND/OR EXPERIENCE

Strongly Preferred Experiences:

• Demonstrated experience working with health insurance plans, including eligibility verification, benefits interpretation, coverage coordination, and claims or billing processes.
• Prior experience managing or coordinating specialty referrals, including obtaining prior authorizations, collaborating with external clinicians, and ensuring continuity of care.
• Familiarity with healthcare administrative workflows and the ability to navigate insurance systems, referral platforms, and electronic health records effectively.

Preferred Skills and Competencies:

• Preferred: two years or more of customer service-related experience.
• Must be able to communicate University insurance requirements to domestic and international students and to interpret insurance policies and regulations to students, parents, University departments, and sponsoring programs.
• Strong work ethic.
• Ability to work effectively independently, while also being able to work as a team member.
• Strong listening and communication skills (written and oral), attention to detail, and ability to be flexible.