[Hiring] Post-Acute Prior Authorization Specialist @OSF HealthCare

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.
• This is an Hourly position.