Medical Insurance Associate (4582)

The primary function of the MIA for the Pre-Arrival Team is to obtain, verify, and confirm patient demographic information, insurance eligibility and coordination of benefits using a variety of mechanisms including, but not limited to, an on line eligibility module, direct to payer websites or calls to payers.

SIU School of Medicine does not participate in the E-Verify program. Employment eligibility will be verified in accordance with applicable state and federal laws.

75% Obtains and Verifies Demographic and Insurance Information
1) Collects pertinent patient demographic information and enter data completely and accurately into practice management system.
2) Collects pertinent patient insurance information and verifies insurance information and eligibility using electronic on line eligibility modules, payer websites or phone calls to payers. Enters data completely and accurately into practice management system.
3) Insures all applicable billing information and requirements are obtained and entered into practice management system.
4) Assists patients in understanding insurance benefits including copays, deductibles and referrals.
5) Accesses GE Eligibility Tool files and insurance websites to assess rejections and contact patients or payers to resolve discrepancies.
6) Accesses affiliated hospital data bases to obtain demographic and/or insurance information.
7) Able to make complex decisions when resolving eligibility related errors found on accounts.
8) Assist Non-RSS team members with possible paper visit creation, patient keeper billing report and/or charge entry if needed.

20% Customer Service
1) Receives calls from patients and other SIU HC staff.
2) Make outbound calls to patients and payers.
3) Maintain strict confidentiality regarding knowledge of all patient information.

5% Other duties as assigned

1. Any one or combination totaling one (1) year (12 months) from the categories below:
   1. 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)
   2. Work experience in a healthcare environment working with medical claims, denials, rejections, referrals, and prior authorizations.

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.