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Billing & Claims Support Specialist (Medical Assistance Consultant II)

Job Requisition ID: 54385
BPIS: 03446 & 11758

Opening Date: 03/19/2026
Closing Date: 04/02/2026
Agency: Department of Healthcare and Family Services
Class Title: MEDICAL ASSIST CONSULTANT II - 26502
Skill Option: None
Bilingual Option: None
Salary: Anticipated starting salary $5384/month / Full salary range $5,384 - $7,631/month
Job Type: Salaried
Category: Full Time
County: Sangamon
Number of Vacancies: 2
Bargaining Unit Code: RC062 Technical Employees, AFSCME
Merit Comp Code:

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.

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 candidate to serve as Prior Approval Specialist. Under the direction of the Prior Approval and Customer Relations/Special Case Programs managers, this position conducts professional work in the interpretation of Department policies, procedures, instructions, in the prior approval process for durable medical equipment and specialized medical services. This position will provide a current status of prior, approval requests within the MMIS database to providers of these services.

The ideal candidate will possess strong communication skills, confidence, the ability to thrive in high volume and fast paced environment, and problem-solving skills to ensure operations are running effectively.

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 Prior Approval Specialist and conducts professional work in the interpretation of Department policies, procedures, instructions, and other related aspects regarding the Prior Approval process for durable medical equipment and specialized medical services
Responds to telephone and/or written correspondence to/from medical vendors, agency staff, and the general public regarding inquiries, complaints, and requests for information and assistance
Researches and analyzes prior approval requests submitted by medical providers to determine action for entering prior approvals
Stays up to date on policy and procedure changes
Attends meetings
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 professional experience in fields related to medical social work

Preferred Qualifications

Licensure in one of the following specialties: Registered Nurse, Speech-Language Pathologist, Respiratory Therapist, Physical Therapist, or Occupational Therapist
Three (3) years of experience working with medical terminology
One (1) year of experience working with federal, state and local legislation and agency requirements pertinent to public assistance, medical care and rehabilitation assistance
One (1) year of experience providing consultation and instruction related to professional and medical social casework
One (1) year of experience providing customer service to medical provider offices on behalf of a payer
One (1) year of experience addressing policies and procedural inquiries from providers, interest groups and the general public

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
The conditions of employment listed her are incorporated and related to any of the job duties as listed in the job description

Work Hours: Monday - Firday 8:30am - 5:00pm
Headquarter Location: 201 S Grand Ave E, Springfield, Illinois, 62704
Work County: Sangamon
Agency Contact: HFS.DMPApps@illinois.gov
Posting Group: Health Services

This position DOES NOT 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:

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