Medical Insurance Associate

University of Illinois Urbana-Champaign•Urbana, IL

14h•Onsite

About The Position

Acts as a representative of the Student Insurance Office and a liaison between students and the plan. Participates in campus events where Student Insurance presence is requested. Communicates information about Student Insurance programs and services as needed. Performs basic customer service duties including phone calls, emails, and in-person consultations. Escalates complex issues to the appropriate department personnel. Responsible for customer interaction that will require the ability to work independently with students and staff. Also includes providing insured clients with accurate, detailed information related to a variety of insurance issues to ensure their understanding about the plan's policy and benefits, including explanations about the various components of each benefit, the importance of adhering to timely filing schedules, payment allocation, the appeal process, the enrollment period, and other issues. Perform a variety of support services to meet daily operational needs of the department. Facilitate processing functions related to each semester's enrollment period activities. Responsible for traveling and participating in outreaches throughout the year to educate new students during the orientation for each semester with compassion and understanding. Document internal office practices/policies. Maintain confidential records and perform related processing functions during enrollment period such as reviewing insurance waivers by contacting insurance carriers for coverage eligibility and benefit information to meet waiver requirements. Perform other assigned duties.

Requirements

One (1) year (12 months) of college coursework in a health-related field, business administration/management, human resource management, or closely related fields (30 semester hours equals one year).
OR Associate’s Degree (60 semester hours) equals eighteen months.
Work experience in a healthcare environment working with medical claims, denials, rejections, referrals, and prior authorizations.
Understanding medical terms and insurance language.
Familiarity with different types of insurance policies and coverage options.
Knowledge of regulations, such as HIPAA and FERPA.
Understanding customer service best practices and techniques.
Awareness of procedures for processing insurance claims.
Strong communication skills.
Ability to analyze insurance-related issues and provide resolution or escalation.
High level of accuracy in reviewing documentation.
Ability to understand and empathize with students’ situations and provide compassionate support.
Capability to make informed decisions based on data and policy guidelines.
Ability to work effectively as part of a team, collaborating with other representatives and departments.
Competence in composing, sending, and organizing emails and text messages efficiently.
Accuracy in entering information into spreadsheets or databases.
Proficiency in using word processing, spreadsheet, and email software.
Proficiency with scheduling software like Microsoft Outlook Calendar.
Efficiently managing time to handle multiple tasks and meet deadlines.

Nice To Haves

Banner experience.
Knowledge of using cloud storage and document management systems like PowerDMS and Box.
Skills in negotiating and mediating between clients and insurance providers to reach satisfactory outcomes.

Responsibilities

Acts as a representative of the Student Insurance Office and liaison between students and the plan.
Participates in campus events where Student Insurance presence is requested.
Communicates information about Student Insurance programs and services.
Performs basic customer service duties including phone calls, emails, and in-person consultations.
Escalates complex issues to the appropriate department personnel.
Provides insured clients with accurate, detailed information related to insurance issues, plan policies, and benefits.
Explains various components of each benefit, adherence to timely filing schedules, payment allocation, appeal process, and enrollment period.
Performs support services to meet daily operational needs of the department.
Facilitates processing functions related to each semester's enrollment period activities.
Travels and participates in outreaches to educate new students during orientation.
Documents internal office practices/policies.
Maintains confidential records and performs processing functions during enrollment period, including reviewing insurance waivers.
Contacts insurance carriers for coverage eligibility and benefit information to meet waiver requirements.
Performs other assigned duties.