Medical Insurance Representative - School of Dental Medicine (CS26-250)

Southern Illinois University Edwardsville•Alton, IL

3d•Onsite

About The Position

Southern Illinois University Edwardsville (SIUE) is seeking a Medical Insurance Representative for the School of Dental Medicine. This role is crucial for managing patient balances, processing insurance claims, and ensuring accurate financial records. SIUE is a premier metropolitan university committed to advancing social and economic mobility and shaping the future workforce. It offers a comprehensive education enriched by research opportunities, preparing students for success in a global marketplace and for positive community impact. As one of the largest employers in the Metropolitan St. Louis area, SIUE has a significant economic impact on the region.

Requirements

High school diploma or equivalent.
Six (6) months of college coursework in a health-related field, business administration/management, human resource management, or closely related fields (30 semester hours equals six months).
Work experience in a healthcare environment working with medical claims, denials, rejections, referrals, and/or prior authorization.
Knowledge of principles and processes for providing customer and personal services.
Ability to evaluate information to determine compliance with standards, laws & regulations.
Ability to apply individual judgment to determine if events or processes comply with laws, regulations or standards.
Basic understanding of medical or insurance billing.
Ability to use computers and computer systems.
Knowledge of the English language including the meaning and spelling of words, rules of composition & grammar.
Must be dependable and possess attention to detail, integrity, stress tolerance, self control and concern for others.

Responsibilities

Under direct supervision of the Accounting Associate, reviews patient balances analyzing the make-up of the balance and communicates this to the patient.
Takes necessary actions to complete or process various types of routine, non-complex claims including third party payers.
Accepts payments and applies them to the patient's account.
Analyzes and reconciles patient accounts referring to patient chart as needed; investigates discrepancies and determines appropriate action required to complete the claim process, billing procedure or adjudication process.