Insurance and Billing Specialist II- Contractual

Towson University; Towson (MD); On-site; USD 42,000 - 65,000; Full time

Job summary

Towson University Health Center is seeking a Billing and Revenue Specialist to manage ICD, CPT, HCPCS coding for visits and ensure accurate claims submission. This role uses Cognizant-TriZetto and Waystar to process electronic claims and payments with emphasis on accuracy and timeliness.

You will train staff on coding practices, reconcile accounts, review denials, and maintain HIPAA/FERPA safeguards while providing excellent customer service to students and families.

Qualifications

• General accounting and bookkeeping knowledge.
• Ability to communicate effectively and train others.
• Experience with insurance billing and revenue cycle processes.

Responsibilities

• Reviews and codes visits using ICD, CPT, HCPCS to maximize revenue.
• Process claims submissions to insurance companies via billing platforms.
• Reconcile payments and balance bills to patient accounts.

Education

Three years accounting clerical experience.

Tools

Cognizant-TriZetto

Waystar

Point and Click Solutions

EHR (Electronic Health Record)

Job description

Responsibilities and Duties

• Reviews, leads, and trains on proper ICD, CPT, and HCPCS codes of visits to maximize revenue generation. Execute insurance and billing procedures required by various commercial health insurance plans (including HMO, PPO) and federal-state programs (ex. Maryland Medicaid).

• Identifies and codes ledger accounts for out-of-pocket payments. Verifies insurance coverage. Collect and compile electronic claims and submit claims to insurance companies via Cognizant-TriZetto platform and Waystar.

• Completes claim forms for payments, follow-ups, payer filings, and appeals. Reviews, reconciles, and follows up on lab invoices including Labcorp and Quest Diagnostics. Reconciles payments and balance bills to the appropriate accounts to optimize collections.

• Authorizes charge tickets and generates payments for patient accounts. Compiles data and generates follow-up reports for the Health Center and insurance companies. Completes denial corrections and resolves accounting discrepancies. Performs analysis of financial transactions and bank deposits.

• Utilize electronic health record for updating and retrieving information regarding patient demographics and insurance eligibility from files and databases.

• In conjunction with the Insurance and Billing Supervisor, serves as a staff point person and trainer for billing issues within Point and Click Solutions electronic health record platform. Works within the 3rd party billing and insurance platform (Cognizant-TriZetto and Waystar) to complete Electronic Funds Transfer (EFT) and Automated Clearinghouse (ACH) transactions.

• Corresponds with students and families to assist with insurance and billing related questions and concerns. Assists with legal and insurance medical record responsibilities.

• Assists with staffing events involving the Health Center including student orientations and other outreach programs.

Qualifications and Skills

Required Qualifications:

• High School Diploma or GED

• Three years accounting clerical experience.

General knowledge of bookkeeping principles, mathematical methods and techniques and accounting standards. Skill in performing mathematical computations; in reviewing and processing financial documents; in reconciling financial data; in operating calculators, keyboards, manual and automated office equipment, personal computers and financial software; in inputting data. Ability to communicate effectively; to prepare written records and reports; to establish and maintain effective work relationships; to lead and train others in assigned accounting clerical or bookkeeping work.

Except for qualifications established by law, additional related experience and formal education in which one has gained the knowledge, skills, and abilities required for full performance of the work of the job class may be substituted for the education or experience requirement on a year-for-year basis with 30 college credits being equivalent to one year of experience.

• Ability to perform complex accounting, auditing, billing, and coding procedures within the Revenue Cycle Management unit of the Towson University student health center.

• Ability to lead and train other staff in proper ICD, CPT, and HCPCS coding to optimize revenue collection.

• Skilled in reviewing and processing insurance claims and other financial documents and reconciling financial data.

• Knowledge of HMO, MCO, PPO, commercial insurance plans, and the joint federal-state program (Medicaid).

• Familiarity with Out-of-Pocket health care costs including; co-pays, co-insurance and deductibles.

• Knowledgeable in medical office practices and electronic medical records.

• Familiarity with HIPAA and FERPA policies and standards specific to preventing data breaches involving PHI, PII, etc.

• Ability to communicate effectively, establish, and maintain effective work relationships.

• Excellent customer service skills.

Preferred Qualifications:

• Certification as a Professional Coder (CPC), Certified Medical Billing Specialist or a Certified Professional Biller.

Organization: Student Affairs Division

Primary Location: Main Campus

Job Posting: Nov 6, 2026