Medical Insurance Representative

The primary function of the MIR for Pre-Arrival is to obtain, verify, and confirm patient demographic information as well as insurance eligibility using a variety of tools and resources. The primary function of the MIR for Non-RSS is to create accurate patient accounts in the practice management system (PMS). This position aids in the efficient operations of change processing for multiple departments within SIU Healthcare. This is an entry-level position which operates under direct supervision performing basic medical insurance processing duties.

75% Obtains and Verifies Demographic and Insurance Information
1. Collects pertinent patient demographic information and enters data completely and accurately into PMS.
2. Accurately collects and enters patient insurance information and eligibility in the PMS by using online eligibility tools, payor websites, and/or phone calls with payors and guarantors/patients.
3. Registers new patients and creates applicable visits via information from Patient Keeper.
4. Retrieves any additional information needed by accessing affiliate hospital data base websites and enters data completely and accurately into PMS.
5. Works Enterprise Task Management (ETM) task within the PMS.
6. Works billing report from Patient Keeper by generating encounters for the physicians' services and handles charge entry, if needed.
7. Reviews and identifies sources of potential patterns causing eligibility related rejections

20% Customer Service
1. Receives calls from payers, patients and/or other SIU staff.
2. Make outbound calls to patients and payers.

5% Other duties as assigned

1. High school diploma or equivalent.
2. Any one or combination totaling six (6) months from the categories below:
   1. 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 six (6) months
   2. Work experience in a healthcare environment working with medical claims, denials, rejections, referrals, and/ or prior authorization.

If you require assistance, please contact the Office of Human Resources at hrrecruitment@siumed.edu or call 217-545-0223 Monday through Friday, 8:00am-4:30pm.

The mission of Southern Illinois University School of Medicine is to optimize the health of the people of central and southern Illinois through education, patient care, research and service to the community.

The SIU School of Medicine Annual Security Report is available online at https://www.siumed.edu/police-security. This report contains policy statements and crime statistics for Southern Illinois University School of Medicine in Springfield, IL. This report is published in compliance with Federal Law titled the

"Jeanne Clery Disclosure of Campus Security Policy and Crime Statistics Act."

Southern Illinois University School of Medicine is an Affirmative Action/Equal Opportunity employer who provides equal employment and educational opportunities for all qualified persons without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, protected veteran status or marital status in accordance with local, state and federal law.

Pre-employment background screenings required.