New

Medical Insurance Specialist (U) (4583)

SIU Medicine
$20.57 - $22.63 Hourly
medical insurance, dental insurance, life insurance, paid time off, paid holidays, sick time, extended sick time, tuition reimbursement, 403(b), retirement plan
United States, Illinois, Springfield
Apr 23, 2026
We recommend using the following browsers to complete the application: Desktop: Google Chrome, Edge with Chromium Mobile: Google Chrome, Safari Description The primary function of the MIS for the Pre-Arrival and Customer Service Teams is to be obtain, verify, and confirm patient demographic information and insurance eligibility using a variety of tools and resources as well as resolve customer calls related to billing issues and disputed accounts. The MIS is also responsible for escalated and disputed patient issues, account write-offs, and other responsibilities outside the Medical Insurance Associate (MIA) and Medical Insurance Representative (MIR) roles. The position is ON SITE only Examples of Duties 65% Obtains and Verifies Demographic and Insurance Information Assist PAT and CS team members with questions and escalations. Assist team members with resolving eligibility errors as Team Lead. Coordinates training of new staff within Pre Arrival & Customer Service Department. Assist with tracking team statistics, including errors and productivity. Assist with auditing and mentoring staff for repetitive errors. Collects pertinent patient demographic information and enter data completely and accurately into practice management system. Collects pertinent patient insurance information and verifies insurance information and eligibility using online eligibility modules, payor websites and/or phone calls to payors and guarantors/patients. Enters data completely and accurately into practice management system. Ensures all applicable billing information and requirements are accurately obtained and entered into practice management system. Assists patients in understanding insurance benefits and updates appropriate co-pays on applicable insurance. Accesses affiliated hospital databases to obtain demographic and/or insurance information. Able to make complex decisions when resolving errors or issues including, but not limited to: Patient billing disputes Returns/Rejections of other colleague invoice reviews Escalated calls Insurance billing discrepancies Insurance, coding and cash management follow ups 30% Customer Service Receives and handles calls from patients, insurance companies, other outside parties and SIU employees. Accurately assists patients in setting up monthly payment plans through SIU or Access One. Make outbound calls to patients and payers. Maintain strict confidentiality regarding knowledge of all patient information. 5% Other duties as assigned Qualifications Credentials to be Verified by Placement Officer Any one or combination totaling two (2) years (24 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 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) Work experience in a healthcare environment working independently with medical claims, denials, rejections, referrals, and prior authorizations. Knowledge, Skills & Abilities (KSAs) Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluating customer satisfaction. Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar. Knowledge of complex medical terminology, hospital or physician billing and coding, referrals, and prior authorizations. Knowledge of arithmetic with the ability to add, subtract, multiply and divide whole numbers, decimals and percentages. Skill in evaluating information to determine compliance with standards. Using relevant information and individual judgment to determine whether events or processes comply with laws, regulations, standards and ensuring that lower-level employees are following standards. Skill in using computers and computer systems (including hardware and software) to program, write, set up functions, enter data, or process information. Ability to pay close attention to details, follow established procedures to complete work tasks and train others in those procedures. Ability to maintain patient confidentiality following HIPAA guidelines and established policies and procedures. Ability to train others and work collaboratively, building strategic relations with colleagues, coworkers, constituents. Ability to plan, assign, and supervise the work of others. Condition of Employment Pursuant to the State Universities Civil Service System, an out-of-state resident who is hired into this position must establish Illinois residency within 180 calendar days of their start date. Supplemental Information If you require assistance, please contact the Office of Human Resources at hrrecruitment@siumed.edu or call 217-545-0223 Monday through Friday, 8:00am-4:30pm. *The mission of Southern Illinois University School of Medicine is to optimize the health of the people of central and southern Illinois through education,* *patient care,* *research and service to the community.* The SIU School of Medicine Annual Security Report is available online at https://www.siumed.edu/police-security. This report contains policy statements and crime statistics for Southern Illinois University School of Medicine in Springfield, IL. This report is published in compliance with Federal Law titled the "Jeanne Clery Disclosure of Campus Security Policy and Crime Statistics Act." Southern Illinois University School of Medicine is an Affirmative Action/Equal Opportunity employer who provides equal employment and educational opportunities for all qualified persons without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, protected veteran status or marital status in accordance with local, state and federal law. Pre-employment background screenings required.