Medical Staff Services Specialist I

About the role

The position serves as a resource for internal departments, committees, hospitals, insurance companies, Federal agencies, and the State of Illinois. This includes all UICOMP physicians, PHDs, APNs, LCSWs, LCPCs and locum tenens. The position coordinates and verifies completeness all forms and Licensure submitted by the various UICOMP clinical departments.

Responsibilities

• Communicates with physicians, coordinators and staff with regard to work progress, flow, deadlines, signatures, etc.
• Serves as a resource for internal departments, committees, hospitals, insurance companies, Federal agencies, and the State of Illinois.
• Coordinates and verifies completeness all forms and Licensure submitted by the various UICOMP clinical departments.
• Uploads and works within internal software database and maintains existing confidential credentialing books for each provider.
• Maintains confidentiality while accessing confidential information to complete assigned duties.
• Compiles, reviews, and submits data required to complete payer spreadsheets.
• Makes sure all credentialing and re-credentialing deadlines are met.
• Reviews physician accreditation guidelines to meet reimbursement requirements.
• Trains staff as needed.
• Participates in meetings with insurance payers to educate and resolve payment or enrollment issues.
• Submits Global Access Security Form for all new/terms providers that grant or terminate their access to Epic EHR/Billing software.
• Monitors and tracks the status of all submissions on an ongoing basis.
• Removes providers who have terminated the Medical Service Plan in compliance with contractual requirements.

Requirements

• High school diploma or equivalent.
• Any one or combination totaling two (2) years (24 months) from the categories below:
  • College coursework in health care administration, health information technology, health sciences, public health, social sciences, business administration, or a closely related field, as measured by the following conversion table or its proportional equivalent: 30 semester hours equals one (1) year (12 months).
  • Associate’s Degree (60 semester hours) equals eighteen months (18 months).
  • 90 semester hours equals two (2) years (24 months).
  • Bachelor’s Degree (120 semester hours) equals three (3) years (36 months).
  • Work experience in a medical setting which could include business administration (office administration, billing, collections), customer service, health information technology, medical insurance, patient admission/registration, patient services, or closely related experience.

Qualifications

• Minimum qualifications include a high school diploma or equivalent.
• Experience in a medical setting, including business administration, customer service, health information technology, medical insurance, patient admission/registration, patient services, or closely related experience.

Skills

• Strong communication and problem-solving skills.
• Ability to manage multiple deadlines and maintain confidentiality.
• Proficiency in using internal software and databases.
• Knowledge of healthcare regulations and insurance processes.

Benefits

• Health, Dental, Vision, Life Insurance.
• Retirement Plan.
• Paid time Off.
• Tuition waivers for employees and dependents.

Pay

$23.32 - $24.76 per hour, commensurate with experience.

Schedule

M - F, 8 a.m. - 4:30 p.m.

Workplace Type

On-Site