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

Remote Full-time
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 post-acute insurance authorization OR Associate's degree in healthcare field with one year of experience in post-acute referral management OR One year of experience in post-acute 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 interpersonal 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). • 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 and cooperate with all to facilitate integrated patient care that exceeds expectation. • 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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