Job Description
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.
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