Post-Acute Authorization Specialist

Job Description

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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.

Overview

Position requires 6 months of successful onsite traiing in Peoria before becoming Hybrid

Position Summary

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 and is 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

REQUIRED QUALIFICATIONS:

Education: 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.

Other Skills/ Knowledge: Solid computer skills, including proficiency with Microsoft software. Demonstrated proficiency in communicating sensitive complex information to persons in a hospital environment.  Demonstrates the 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, interact with patients/families, and perform other activities requiring courtesy and tact.

Preferred Qualifications

Education: Bachelor's degree in a healthcare field.

Other Skills/ Knowledge: Ability to interact with members of the health care team and external personnel in order to exchange and gather patient care data to continue continuity of care. Accurate typing speed of at least 35 words per minute. Proven organizational skills in coordinating services with co-workers and other departments/services. Responds to stressful situations in a calm, rational manner and cooperates with all to facilitate integrated patient care that exceeds expectation. Strong analytical and problem-solving skills with the ability to be detail oriented.

OSF HealthCare is an Equal Opportunity Employer.