Job Description
Performs claims adjudication to ensure efficient claims operation in accordance with the Third Party Payer and Business Associate agreements between the Student Insurance office and the current underwriter of the student plan. Provides in-person service to students. Dispenses policy information, claims advice, procedural information, and provides guidance in benefit decisions to students, families, medical providers, and other University personnel.
Additional Information
University Benefit Highlights:
- Insurance benefits, including health, dental, vision, and life
- Retirement and supplemental retirement planning options
- Tuition waiver benefits available to staff as well as their eligible dependents
- Paid holiday/administrative closures during Thanksgiving and Winter Breaks
- Paid benefit time
Additional University Benefit information, including information regarding eligibility to participate in the State Universities Retirement System and the State of Illinois Group Insurance program, can be reviewed here: https://hr.illinoisstate.edu/benefits/
Qualifications
Required Qualifications
1. Any one or combination totaling two (2) years (24 months), from the categories below:
A. 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)
- 90 semester hours equals two (2) years (24 months)
B. Work experience in a healthcare environment working independently with medical claims, denials, rejections, referrals, and prior authorizations.
Preferred Qualifications
1. Familiarity with policy benefits, exclusions, contract requirements, and with methods for resolving disputes and meeting unique needs.
2. Must know insurance carrier and office policies for processing claims, enrollment eligibility, insurance and medical terminology, and insurance principles.
3. Excellent communication skills are necessary.
4. Must be able to compose correspondence which explains or responds to complex questions about claims or the Student Insurance program.
5. Must comprehend medical terminology.
6. Must be able to recognize errors of understanding and provide clarification using initiative, tact, and judgement.
7. Work on own initiative in accomplishing assigned tasks.
Salary
$20.11 - $23.00 per hour
Links
ISU Jobs Website
Contact Information
University/Agency
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Illinois State University
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Department/College
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Human Resources
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Contact
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Mackenzie Chapman
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Phone Number
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309-438-8311
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Address
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Comments
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