What are the responsibilities and job description for the Billing & Claims Support Specialist (Medical Assistance Consultant II) position at illinois?
Agency: Department of Healthcare and Family Services
Posting ID number: MP45281
Class Title: MEDICAL ASSIST CONSULTANT II - 26502
BPIS: 07783
Skill Option: None
Bilingual Option: None
Start date: 3/6/25
Closing Date/Time: 03/20/2025
Salary: Anticipated starting salary $5179/monthly; Full salary range $5179 - $7341/monthly
Job Type: Salaried
Category: Full Time
County: Sangamon
Number of Vacancies: 1
Plan/BU: RC062
This position is a union position; therefore, provisions of the relevant collective bargaining agreement/labor contract apply to the filling of this position.
All applicants who want to be considered for this position MUST apply electronically through the illinois.jobs2web.com website. State of Illinois employees should click the link near the top left to apply through the SuccessFactors employee career portal.
Applications submitted via email or any paper manner (mail, fax, hand delivery) will not be considered.
Posting Identification Number MP45281
Why Work for Illinois?
Working with the State of Illinois is a testament to the values of compassion, equity, and dedication that define our state. Whether you’re helping to improve schools, protect our natural resources, or support families in need, you’re part of something bigger—something that touches the lives of every person who calls Illinois home.
No matter what state career you’re looking for, we offer jobs that fit your life and your schedule—flexible jobs that provide the gold standard of benefits. Our employees can take advantage of various avenues to advance their careers and realize their dreams. Our top-tier benefits and great retirement packages can help you build a rewarding career and lasting future with the State of Illinois.
Position overview:
The Department of Healthcare and Family Services, Medical Programs/Bureau of Professional and Ancillary Services is seeking to hire a motivated individual with medical knowledge to serve as a Billing & Claims Support Specialist. This position will work to identify and establish billing procedures and ensure compliance with agency regulations through client case review. The ideal candidate will have excellent communication skills and can collaborate across agencies to ensure seamless coverage, in addition to containing knowledge and experience in the fields of medical care.
HFS values employees with different backgrounds, life experiences, and talents.
Employees receive a robust benefit package including:
- Monday-Friday work schedule
- Flexible work schedules are available in many program areas. (Remote work may be an option for certain positions.)
- Health, Life, Vision, and Dental Insurance
- Pension Plan
- Paid Parental Leave
- Deferred Compensation Program and other pre-tax benefit programs (Medical/Daycare)
- Employees earn (12) paid Sick Days annually.
- New Employees earn (10) paid Vacation Days their first year of service and can earn up to (25) paid Vacation Days annually.
- Employees earn (3) paid Personal Days annually.
- (13-14) paid holidays annually (based on start date)
If you are seeking a new opportunity, and this position appeals to you, please apply today!
At the Illinois Department of Healthcare and Family Services (HFS), we value staff as our greatest asset. We work in a spirit of teamwork to help millions of Illinoisans access high quality healthcare and fulfill child support obligations to advance their physical, mental, and financial well-being. We provide healthcare coverage for children and adults through Medicaid and other medical programs, and we help ensure that children receive financial resources from both their parents through Child Support Services. The HFS Office of the Inspector General investigates, audits and reviews program activity to ensure the integrity of our programs is maintained.
HFS is committed to promoting and preserving a workplace culture that embraces diversity, equity, and inclusion. We welcome and value employees with different backgrounds, life experiences, and talents. It is the collective sum of our individual differences that provides a broad perspective, leading to greater innovation and achievement. In recruiting for our team, we recognize the unique contributions of each applicant regardless of culture, ethnicity, race, national origin, sex, gender identity and expression, age, religion, disability, and sexual orientation. HFS is an equal opportunity employer.
Essential Functions
- Under direction, serves as a Billing and Claims Support Specialist by conducting professional activities in the interpretation and determination of billing procedures utilizing Current Procedural Technology (CPT), Healthcare Common Procedure Coding System (HCPCS) and International Classifications of Disease (ICD-9) coding methodologies relating to the Professional Provider Support program
- Interprets Department policies and procedures for medical providers, county, field, and other agency personnel
- Serves as liaison to medical providers, professional organizations, and agency personnel
- Conducts training and educational seminars for medical providers participating in the Medical Assistance Programs
- Serves as back-up to the professional Providers Support and the Durable Medical Equipment/Optical and Pharmacy Programs
- Performs other duties as required or assigned which are reasonably within the scope of the duties enumerated above
Minimum Qualifications
- Requires knowledge, skill, and mental development equivalent to completion of four (4) years of college, with courses in medical social work
- Requires two (2) years of professional experience in fields related to medical social work
Preferred Qualifications
- Minimum of one (1) year of experience utilizing MMIS’ eligibility and provider payment databases
- Minimum of one (1) year of customer service experience to medical provider offices on behalf of a payer
- Minimum of one (1) year of experience utilizing reference materials such as provider billing instruction manuals
- Minimum of one (1) year of experience using CPT, HCPCS ad ICD-9 coding methodologies
- Minimum of one (1) year of experience with an enterprise data warehouse including but not limited to the utilization of the BiQuery tool to obtain claims data
- Minimum of two (2) years of experience working with medical social case work principles and techniques
- Minimum of two (2) years of experience with Federal, State, local legislation, and agency requirements pertinent to public assistance, medical care, and rehabilitation assistance
- Minimum of two (2) years of experience working with medical and social work literature, individual, health, rehabilitation and educational needs and community and State resources
Specialized Skills
- Requires one (1) year of experience utilizing MMIS’ eligibility and provider payment databases
- Requires one (1) year of customer service experience to medical provider offices on behalf of a payer
- Requires one (1) year of experience utilizing reference materials such as provider billing instruction manuals
- Requires one (1) year of experience using CPT, HCPCS and ICD-9 coding methodologies
- Requires one (1) year of experience with the enterprise data warehouse including but not limited to the utilization of the BiQuery tool to obtain claims data
Conditions of Employment
- Requires completion of a background check and self-disclosure of criminal history
- Requires the ability to utilize and maintain state issued equipment such as a laptop and/or cell phone
- The conditions of employment listed here are incorporated and related to any of the job duties as listed in the job description
Work Hours: Monday - Friday 8:30 a.m. - 5:00 p.m.
Work Location: 201 South Grand Ave E Springfield, IL 62704-3803
Email: HFS.DMPApps@illinois.gov
Posting Group: Health Services
This position DOES contain “Specialized Skills” (as that term is used in CBAs).
APPLICATION INSTRUCTIONS
Use the “Apply” button at the top right or bottom right of this posting to begin the application process.
If you are not already signed in, you will be prompted to do so.
State employees should sign in to the career portal for State of Illinois employees – a link is available at the top left of the Illinois.jobs2web.com homepage in the blue ribbon.
Non-State employees should log in on the using the “View Profile” link in the top right of the Illinois.jobs2web.com homepage in the blue ribbon. If you have never before signed in, you will be prompted to create an account.
If you have questions about how to apply, please see the following resources:
State employees: Log in to the career portal for State employees and review the Internal Candidate Application Job Aid
Non-State employees: on Illinois.jobs2web.com – click “Application Procedures” in the footer of every page of the website.
The main form of communication will be through email. Please check your “junk mail”, “spam”, or “other” folder for communication(s) regarding any submitted application(s). You may receive emails from the following addresses:
- donotreply@SIL-P1.ns2cloud.com
- systems@SIL-P1.ns2cloud.com
Salary : $5,179 - $7,341
