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Medical Insurance Specialist

2 months ago

Normal, United States Illinois State University Full time

Medical Insurance Specialist

Job no: 519065
Work type: On Campus
Location: Normal, Illinois

Title: Medical Insurance Specialist
Division Name: Student Affairs
Department: Health Services

Job Summary

Performs claims adjudication to ensure efficient claims operation in accordance with the Third Party Payer and Business Associate agreements between the Student Insurance office and the current underwriter of the student plan. Provides in-person service to students. Dispenses policy information, claims advice, procedural information, and provides guidance in benefit decisions to students, families, medical providers, and other University personnel.

Additional Information

University Benefit Highlights:

- Health, dental, vision, and life insurance
- Retirement and supplemental retirement
- Tuition waiver benefits are available to staff as well as their eligible dependents.
- Paid holiday/administrative closures during Thanksgiving and Winter Breaks
- Paid vacation and sick time

For more University Benefit information:

Information regarding eligibility for participation in the State Universities Retirement System and the State of Illinois Group Insurance program can be reviewed here

Salary Rate / Pay Rate

$20.11 to $23.00 per hour

Required Qualifications

1. Any one or combination totaling two (2) years (24 months), from the categories below:
A. 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)
B. Work experience in a healthcare environment working independently with medical claims, denials, rejections, referrals, and prior authorizations.

Preferred Qualifications

1. Familiarity with policy benefits, exclusions, contract requirements, and with methods for resolving disputes and meeting unique needs of students, parents, hospital and physician representatives and other insurance carries.
2. Must know insurance carrier and office policies for processing claims, enrollment eligibility, insurance and medical terminology, and insurance principles.
3. Excellent communication skills are necessary.
4. Must be able to compose correspondence which explains or responds to complex questions about claims or the Student Insurance program.
5. Must comprehend medical terminology.
6. Must be able to recognize errors of understanding and provide clarification using initiative, tact, and judgment.
7. Ability to work on own initiative in accomplishing assigned task

Work Hours

8:00am to 4:30pm, Monday through Friday

Functional Expectations

Must be able to complete the following with or without a reasonable accommodation:

1. Remain at a workstation for extended periods
2. Move about in various locations across campus as needed to complete day-to-day work
3. Effectively communicate on a daily basis.

Proposed Starting Date

August 2024

Optional Applicant Documents

Transcripts - See Special Instructions to Applicants for additional options
Related Certifications (i.e. Certified Professional Coder (CPC); Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT) or National Healthcareer NHA)’s Billing and Coding Specialist (CBCS).
Certification of Retirement Annuity

Please Note : These documents may be submitted online in order to complete the application process. Please have these documents ready prior to clicking on "Apply"