Medical Insurance Associate

Southern Illinois University Edwardsville
2800 College Avenue
Alton, IL 62002
United States

Application Closing Date
Manages Others
Experience Required
Degree Required
Accepts NHA Certifications
Security Clearance Required
From $35,946 To $35,946
Per Year    
Employment Type
Work Schedule
No Travel

Job Description

Illinois Residency Requirement: This position requires current Illinois residency to apply.

The SIU School of Dental Medicine is accepting applications for a full-time Medical Insurance Associate to work at the Alton, Illinois clinic. Working under the general supervision of an Accounting Associate, the Medical Insurance Associate will interpret data arising from moderately complex dental claims using detailed knowledge of dental procedures and codes. The Associate will review patient accounts, analyzing the make-up of the balance including payments from various third-party payers, any commercial insurance carriers and/or Medicaid, and communicate the balance totals to the clinic patients.

As part of their analysis, the selected candidate will interpret the coding in accordance with complex reimbursement policies and coordination of benefits, review and examine charges for consistency and accuracy indicated per chart notes while interpreting medical codes or procedures performed according to coding standards which may require clarification with codes provided by American Dental Association (ADA). Additionally, the Medical Insurance Associate will:
-Process patient payments, both in person and mailed, and apply to accounts. Will also reconcile assigned cash drawer daily as well as ensure balancing totals to the control amount.
-Investigate discrepancies to determine appropriate action in order to complete the claim process, billing process or adjudication, and post and adjust files to accurately reflect findings.
-Respond to a variety of questions concerning the status of claims/treatments, account balances and charges or payments as well as maintain good customer service with all patients interpreting and explaining their account as needed.
- Enter and maintain insurance templates as well as patient-guarantor-insurance information in patient charts, and serve as a back-up for printing insurance claims and allocating insurance payments.

Other duties and responsibilities may be assigned based on department need. The hours for this position are Monday – Friday, 8:00 a.m. – 4:30 p.m. [37.5 hours weekly] and require no weekend or evening hours. The University, including dental clinics,) is closed for major holidays including Martin Luther King Day, Memorial Day, July 4, Labor Day, Thanksgiving (Thursday and Friday) and the week between Christmas and New Year’s Day. Additional holidays may be assigned based on the state of Illinois calendar. Full-time SIUE employees receive an excellent array of benefits that include:
*Medical, dental and vision insurance;
*Life insurance;
*SURS retirement plan;
*Supplemental retirement savings plans;
*Paid vacation and sick leave accrual;
*Generous holiday schedule/paid holidays;
*WorkLife programs;
*Employee Assistance Program (mental health and wellness);
*Employee discounts (local and national retailers);
*University tuition waivers (full-time receive 100% waiver of tuition)

For more about our benefits and employee services, visit:

 Southern Illinois University Edwardsville nurtures an open, respectful, and welcoming climate that facilitates learning and work. SIUE is committed to education that explores the historic significance of diversity in order to understand the present and to better enable our community to engage the future. Integral to this commitment, Southern Illinois University Edwardsville strives for a student body and a workforce that is both diverse and inclusive. We strongly encourage candidates from historically underrepresented groups, including women, members of racially minoritized groups, and individuals with disabilities, to apply. For more on our Statement of Diversity, visit SIUE Mission, Goals and Plans
Job Requirements
Any one or any combination that equals one year from the categories below:
(a) Experience comparable to experience performed at the Medical Insurance Representative level or in other positions of comparable responsibility within the health insurance area.
(b) College credit for course work in insurance/benefits administration, human resource management, health information management, finance, accounting or closely related fields such as business administration and/or business management:
- 30 semester hours equals six months.
- 60 semester hours equals one year.
- 90 semester hours equals two years.
- 120 semester hours or higher equals three years.

Please Note: The following medical billing certifications satisfy six months of the above requirement: Certified Professional Coder (CPC); Registered Health Information Technician (RHIT); Certified Coding Specialist (CCS); Registered Health Information Administrator (RHIA); National Healthcareer Association(NHA).
Southern Illinois University Edwardsville
Jennifer Oates-Blair
Office of Human Resources Campus Box 1040
Edwardsville IL 62026
United States
Southern Illinois University Edwardsville Jennifer Oates-Blair