Medical Insurance Representative - School of Dental Medicine (CS26-250)

About the role

Under direct supervision of the Accounting Associate, reviews patient balances analyzing the make-up of the balance and communicates this to the patient. Takes necessary actions to complete or process various types of routine, non-complex claims including third party payers. Accepts payments and applies them to the patient's account. Analysis of a patient's account includes interpreting the coding and applying complex reimbursement policies and coordination of benefits. Third party payers include all commercial insurance carriers and Medicaid. Analyzes and reconciles patient accounts referring to patient chart as needed; investigates discrepancies and determines appropriate action required to complete the claim process, billing procedure or adjudication process.

Minimum Acceptable Qualifications

• High school diploma or equivalent
• Any one or combination totaling six (6) months from the categories below:
  • College Coursework In a Health-related Field, Business Administration/management, Human Resource Management, Or Closely Related Fields, As Measured By The Following Conversion Table Or Its Proportional Equivalent: 30 semester hours equals six (6) months
  • Work experience in a healthcare environment working with medical claims, denials, rejections, referrals, and/or prior authorization
• Knowledge of principles and processes for providing customer and personal services
• Ability to evaluate information to determine compliance with standards, laws & regulations
• Ability to apply individual judgment to determine if events or processes comply with laws, regulations or standards
• Basic understanding of medical or insurance billing
• Ability to use computers and computer systems
• Knowledge of the English language including the meaning and spelling of words, rules of composition & grammar
• Be dependable and possess attention to detail, integrity, stress tolerance, self control and concern for others

Additional Information

• FLSA: Non-Exempt
• Illinois Residency Requirement: Pursuant to the State Universities Civil Service System, out-of-state candidates must establish Illinois residency within 180 calendar days of the start date for this position. Illinois residency requires proof of a valid Illinois Driver's License or state of Illinois ID Card. Failure to produce the required documentation within 180 calendar days is grounds for immediate separation.
• Classification: State Universities Civil Service System Classification Number: 4581 – SUCSS Classification Title
• Veterans: Veterans who qualify for preference must provide proof of eligibility within ten (10) working days of submitting an application. The required proof of eligibility includes, at a minimum, a copy of the veteran's DD214/DD215 form (Department of Defense), NGB22 form (National Guard), or Discharge Orders or DD256 Discharge Certificate (Reserves).
• Pre-Employment Screening: All external candidates who receive a job offer will be required to undergo pre-employment screening for this position. The screening process will encompass a criminal background check and, where applicable, other background checks such as a drug screen, verification of employment and education or licensure/certification, reference checks, and/or checks with relevant government registries. All job offers are contingent upon successful completion of the required screening process.
• Work Authorization: SIUE will only employ those who are legally authorized to work in the United States. Visa sponsorship for this position will not be provided. International students at SIUE on F-1 or J-1 visas are not eligible for full-time or part-time civil service positions with permanent status.
• Accommodation: If you are unable to utilize our online application system and need to request an accommodation, please reach out to us at 618-650-2190 or via email at careerinfo@siue.edu

This response is AI-generated, for reference only.