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This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.
Role Description
The Post-Acute Authorization Specialist in the OSF Care Management department is responsible for initiating and obtaining new insurance authorization requests for post-acute services.
Works collaboratively with case management team, hospital care team, community partners, and insurance companies to ensure that patient care needs are met regarding post-acute care prior authorizations.
Obtains and maintains contacts with insurance companies to streamline barrier removal.
Maintains knowledge of payer portal functionality and medical necessity requirements for post-acute care.
Understands payer requirements and how to apply benefits in various circumstances for post-acute care.
Responsible for identifying medical criteria for post-acute care from chart review and developing an effective clinical packet to justify the level of care needed.
Qualifications
High school diploma/GED with two years’ experience in insurance authorization OR Associate's degree in healthcare field with one year of experience in referral management OR One year of experience in insurance authorization.
Solid computer skills, including proficiency with Microsoft software.
Demonstrated proficiency in communicating sensitive complex information to persons in a hospital environment.
Ability to work independently and execute their own workload.
Critical thinking ability necessary to prioritize workload to ensure tasks are completed in a timely manner and within established timeframe.
Interpersonal skills necessary to facilitate communication with team members, department staff, and external personnel.
Ability to interact with patients/families and perform other activities requiring courtesy and tact.
Requirements
Bachelor's degree in a healthcare field (preferred).
Ability to interact with members of the health care team and external personnel to exchange and gather patient care data.
Accurate typing speed of at least 35 words per minute.
Proven organizational skills in coordinating services with co-workers and other departments/services.
Ability to respond to stressful situations in a calm, rational manner.
Strong analytical and problem-solving skills with the ability to be detail oriented.
Benefits
Expected pay for this position is $21.72 - $25.55/hour. Actual pay will be determined by experience, skills, and internal equity.
