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Job description
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Description
Experience and familiarity with SIU Medicine's payer contracts, reimbursement arrangements, credentialing operations, and key payer relationships will help prevent delays that could negatively affect provider participation, patient access, billing, and revenue. This temporary support will also ensure that time-sensitive contract negotiations, renewals, credentialing matters, and payer issues continue to be addressed until a permanent replacement is hired and successfully transitioned into the role.
Examples of Duties
The extra-help employee will provide interim support for managed care contracting and provider credentialing, including assisting with payer contract negotiations, renewals, implementation, and issue resolution; monitoring reimbursement and contract performance; supporting payer enrollment, credentialing, recredentialing, and hospital privileging activities; and helping maintain continuity of critical operations until the position is permanently filled. She would be assisting with many of the duties she did prior to separation. Assisting with cred committee and answering questions from staff. Managed Care and payer issues. Assisting with analysis for an ongoing payer negotiation and answering questions around processes.
Qualifications
High school diploma or equivalent.
Any one or combination totaling two (2) years (24 months) from the categories below:College course work in health care administration, health information technology, health sciences, public health, social sciences, business administration, or a closely related field, 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)
Bachelor's Degree (120 semester hours) equals three (3) years (36 months)
Work experience in a medical setting which could include business administration (office administration, billing, collections), customer service, health information technology, medical insurance, patient admission/registration, patient services, or closely related experience.
Six (6) months of work experience comparable to that of the Medical Staff Services Specialist I of the series.
Knowledge, Skills & Abilities (KSA's)
Ability to communicate properly and effectively in verbal and written form with various levels of Hospital, College, and Medical Staff.
Ability to work independently, set work priorities and determine short- or long-term goals, and strategies to achieve them.
Ability to learn and utilize Medical Staff credentialing software and other information technology-related work products.
Ability to learn and apply the content of Medical Staff Organizational Documents.
Ability to learn and apply state and regulatory standards for Medical Staff.
Maintain confidentiality regarding legal matters, privacy issues, information technology, and data integrity.
Understand clinical competence evaluation concepts, key functions, terminology, and work products, including evaluation tools and techniques used.
Ability to adapt behavior in response to new information or changing circumstances.
Condition of Employment
Pursuant to the State Universities Civil Service System, an out-of-state resident who is hired into this position must establish Illinois residency within 180 calendar days of their start date.
If you require assistance, please contact the Office of Human Resources at or call 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 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."
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Worksite address
springfield, IL, 62777, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.