at OSF HealthCare (Main Office) in East Peoria, Illinois, United States
Job Description
Overview
Expected pay for this position is $21.30/hour. Actual pay will be determined by experience, skills and internal equity.
This job is located in Peoria,IL.
POSITION SUMMARY: The Patient Specialty Services Navigator is responsible for being a dedicated point of contact to support patients through the health system for labs, procedures, office visits and exams, radiology studies, specialty referrals, insurance pre-certifications and authorizations for medications and appointments, completing insurance appeals, coordinating care with social support services and assisting with financial assistance for pharmaceutical and charity care programs. Acts as a liaison between insurance companies and patients by initiating financial counseling prior to service when coverage/authorization problems are identified. The Patient Specialty Services Navigator is dedicated to elevating the patient experience through their care journey.
Qualifications
REQUIRED QUALIFICATIONS: Education: High School/GED Experience: 2 years of working experience in healthcare financial services, insurance authorization, insurance verification, appeals, billing, registration, or MOA/CMA role. 2 years experience with electronic medical record systems. 2 years of working knowledge of reading, analyzing, and extracting documentation in patient medical charts to complete pre-certifications, pharmaceutical authorizations, procedure and testing authorizations, and the insurance appeals. Other skills/knowledge: Excellent interpersonal and communication skills. Solid computer skills, including proficiency with Microsoft software. Strong analytical and problem solving skills, with the ability to be detail oriented.
PREFERRED QUALIFICATIONS: Education: Associates Degree in healthcare or business Experience: 2 years of working knowledge of pre-certification/prior authorization procedures, advanced medical terminology, reimbursement and regulatory issues, insurance functions and terminology, and utilization of charity care programs. 3 years in a healthcare setting with working knowledge of insurance and appeals experience related to denials management in addition to heavy phone work preferred. Nationally recognized Revenue Cycle certification.
OSF HealthCare is an Equal Opportunity Employer.
EOE