Medical Insurance Specialist

UIC; Peoria (IL); Hybrid; USD 32,000 - 34,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Life insurance

Retirement plan

Paid time off

Tuition waivers

Job summary

The University of Illinois College of Medicine Peoria (UICOMP) is hiring a Medical Insurance Specialist to independently manage the follow-up of denied or rejected insurance claims and ensure accurate patient accounts receivable.

Responsibilities include addressing denials, writing appeals, coordinating with billing, coding and clinical staff, and maintaining Epic documentation. This on-site role is based in Peoria, IL with standard daytime hours.

Qualifications

• Two years in healthcare claims, denials, or related follow-up.
• Experience with payer communications and appeals.
• Illinois Residency is required within 180 days of employment.

Responsibilities

• Follow up on unpaid or denied claims to secure timely reimbursement.
• Analyze denial reasons and file appeals.
• Contact payers via portals to resolve balances.
• Collaborate with billing, coding and clinical staff for documentation.
• Maintain Epic records of follow-up activities.
• Identify recurrent denial trends and escalate when needed.
• Validate payments and adjustments for accuracy.
• Support process improvements and staff training.

Skills

Claims processing

Denials management

Epic navigation

Billing collaboration

Education

Associates degree

Health-related coursework

Tools

Epic

Job description

Work Schedule: M - F, 8 a.m. - 4:30 p.m.

Shift: Days

# of Positions: 3

Workplace Type: On-Site

Salary Range (commensurate with experience): $22.93 - $24.34

Please note that this position is not remote and is onsite in Peoria, IL.

About UICOMP

The University of Illinois College of Medicine Peoria (UICOMP) educates 244 medical students and nearly 300 physician residents annually. It is one of four campuses that make up the nation's largest public medical school. The Peoria campus is known among students for its small class sizes, rigorous curriculum and hands-on clerkships; to residents and fellows for the strong academic setting, large referral base and exceptional facilities; and by physicians seeking the ideal combination of teaching and practicing medicine in a research-based university setting.

This position is intended to be eligible for benefits . This includes Health, Dental, Vision, LifeInsurance, a Retirement Plan, Paid time Off, and Tuition waivers for employees and dependents.

Position Summary

The Medical Insurance Specialist independently submits or takes the necessary actions to resolve rejected or denied insurance claims by performing all collection tasks as assigned utilizing collection processes with a high level of knowledge, skills, abilities, and experience. The follow-up position will assume duties as a collector/denial specialist, to manage patient accounts receivable from the point of resubmission of rejected or denied medical claims through final resolution. Identify and address denials by writing appeal letters and ensure account balances are correct based on payer contract terms. Works under general supervision from the Revenue Cycle Manager.

Duties & Responsibilities

• Conduct follow-up on unpaid or denied claims to ensure timely and accurate reimbursement.
• Analyze denial reasons and take appropriate action to appeal or resubmit claims.
• Contact payers and utilize online portals to resolve outstanding account balances.
• Collaborate with billing, coding and clinical staff to gather necessary documentation for appeals or corrections.
• Track and document follow-up activities in Epic.
• Quickly identify and solve problems, escalating recurring denial trends or payer issues to reimbursement coding specialist when necessary.
• Responsible to validate the payments and adjustments made on accounts are correct.
• Maintains daily work queues.
• Acts as a liaison between insurance and providers to ensure coverage and benefits are active at the time of billing.
• Identify authorization numbers saved in the system and attach them to our claims as needed for processing.
• Assist with training and continuous education for billing staff to ensure adherence to ethical billing practices.
• Perform other related duties as assigned, including supporting process improvements and serving as a technical resource and duties that are consistent with the lower level of the medical insurance series.

Minimum Qualifications

• Any one or combination totaling two (2) years (24 months), from the categories below:
  • 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)
• Work experience in a healthcare environment working independently with medical claims, denials, rejections, referrals, and prior authorizations.

Sponsorship for work authorization is not available for this position.

Illinois Residency is required within 180 days of employment.

The University of Illinois System is an equal opportunity employer, including but not limited to disability and/or veteran status, and complies with all applicable state and federal employment mandates. Please visit Required Employment Notices and Posters to view our non-discrimination statement and find additional information about required background checks, sexual harassment/misconduct disclosures, and employment eligibility review through E-Verify.

Artificial Intelligence (AI) tools may be used in some portions of the candidate review process for this position, however, all employment decisions will be made by a person.

Looking for more University of Illinois positions?

We invite you to search for positions at each of the University of Illinois locations, the University of Illinois System Office and the University of Illinois Foundation. The University of Illinois System Office supports the primary missions of teaching, research, public service, and economic development for all of the Universities and offers positions in all locations. The University of Illinois Foundation is the official fundraising and private gift-receiving agency for the University of Illinois and also offers position in all locations. Click the links below to search for other University of Illinois positions.

The University of Illinois System is an equal opportunity employer, including but not limited to disability and/or veteran status, and complies with all applicable state and federal employment mandates. Please visit Required Employment Notices and Posters to view our non-discrimination statement and find additional information about required background checks, covid sexual harassment/misconduct disclosures, and employment eligibility review through E-Verify.

Artificial Intelligence (AI) tools may be used in some portions of the candidate review process for this position, however, all employment decisions will be made by a person.