New

Medical Insurance Representative (U) (4581)

SIU Medicine
$33,277.50 - $36,605.25 Annually
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
Oct 24, 2025
We recommend using the following browsers to complete the application: Desktop: Google Chrome, Edge with Chromium Mobile: Google Chrome, Safari Description The Medical Insurance Representative (MIR) for Pre-Arrival/Customer Service plays a key role in ensuring accurate and complete patient demographic and insurance information prior to services being rendered. This entry-level role operates under direct supervision and involves tasks such as: Verifying and confirming patient demographics and insurance eligibility using various tools and systems Ensuring appropriate reimburse for professional services by following SIU Healthcare's credit and accounts receivable polices Taking and receiving patient calls, processing payment and answering billing inquires Supporting multiple departments by managing efficient change processing. This position is crucial to revenue cycle integrity and provides essential support in delivering high-quality administrative service within a healthcare setting. Examples of Duties Account Maintenance 45% Collect and accurately enter patient demographic information into the Practice Management System (PMS). Obtain, verify, and input insurance information and eligibility using online tools, payer websites, and direct communication with insurers and patients. Retrieve necessary information from affiliate hospital databases and enter data into PMS. Work Enterprise Task Management (ETM) tasks within the PMS. Identify and review eligibility-related rejections and patterns. Respond to insurance team inquiries. Determine accounts that require maintenance and prepare appropriate adjustments or corrections. Analyze credit balances and initiate necessary actions. Customer Service 45% Receive and respond to calls from patients, payers, and SIU staff regarding billing inquiries, disputes, or balances. Respond to inquiries via phone, email, mail, or fax. Place outbound calls to patients to resolve outstanding balances through payments, payment plans, or financial assistance. Process credit card payments securely and accurately. Work reports to resolve address discrepancies. Manage ETM tasks related to patient balances and determine appropriate next steps. Route inquiries or disputes to the appropriate teams via ETM. Review Explanation of Benefits (EOBs) to verify balances or help resolve patient issues. Reception Area Coverage 5% Assist patients in person who come onsite with inquiries, disputes, or who wish to make payments. Other Duties 5% Perform additional related duties as assigned to support departmental and organizational operations. Qualifications Credentials to be Verified by Placement Officer 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, Skills & Abilities (KSA's) 1. 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. 2. Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar. 3. Knowledge of medical terminology and hospital or physician billing, coding, referrals, and prior authorizations. 4. Knowledge of basic arithmetic with the ability to add, subtract, multiply and divide whole numbers, decimals and percentages. 5. Skill in using computers and computer systems (including hardware and software) to program, write, set up functions, enter data, or process information. 6. Ability to pay close attention to details and follow established procedures in completing work tasks. 7. Ability to maintain patient confidentiality following HIPAA guidelines and established policies and procedures. 8. Ability to convey moderately complex billing, claims, referral, and prior authorization information to patients and staff. 9. Ability to train others to work collaboratively, building strategic relations with colleagues, coworkers, constituents. 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.