Medical Insurance Associate(4582)

Siu Medicine Office Of Population Science And Policy • Springfield, IL

403d • $38,896 - $42,786

About The Position

The Medical Insurance Associate position at SIU Medicine is primarily responsible for assisting patients in navigating their insurance needs within the outpatient clinic. This role involves managing referrals, pre-authorizations, and ensuring compliance with insurance procedures to facilitate patient care. The associate acts as a resource for clinical staff and serves as a liaison between patients, healthcare providers, and insurance companies.

Requirements

• 1 year of work experience in a healthcare environment working with medical claims, denials, rejections, referrals, and prior authorizations.
• Associate's degree in a health-related field, business administration/management, or closely related fields.

Responsibilities

• Independently initiates and completes managed care referrals/pre-authorizations as indicated by patients' needs and insurance requirements.
• Reviews patient medical records for necessary documentation and disseminates the appropriate information to managed care organizations.
• Schedules patients' tests, procedures, and referrals to specialty offices according to physician orders and the patient's insurance.
• Prepares lab orders, assigns insurance codes, and faxes orders to the facility prior to scheduled tests.
• Calls patients to relay dates, times, and special instructions for tests and referral appointments, documenting required information into the electronic health record.
• Acts as a liaison and advisor for patients, physicians, hospitals, insurance companies, and government agencies regarding documentation and authorization procedures.
• Secures additional health information from patients and initiates follow-up discussions with managed care organizations.
• Serves as a patient advocate in obtaining timely referrals to specialist physicians and health care agencies.
• Reviews and analyzes processing procedures to identify potential problem areas and improve processing procedures.
• Acts as an expert resource on managed care issues, responding to questions from various stakeholders.

Benefits

• Disability insurance
• Health insurance
• Dental insurance
• Tuition reimbursement
• Paid time off
• Life insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree