OSF HealthCare

Integrated health system operating hospitals

Specialty Services Patient Navigator

Clinical Support & Patient AdministrationUpdated on Nov 11

Full-timePeoria, IL, USA$22.27 - $26.20 /hr

About the Job

Requirements

A high school diploma or GED is required.
One year of experience in healthcare financial services, insurance authorization, insurance verification, appeals, billing, registration, or a Medical Office Assistant or Certified Medical Assistant role is required.
One year of experience with electronic medical record systems is required.
One year of experience reading, analyzing, and extracting documentation from patient medical charts to complete pre-certifications, pharmaceutical authorizations, procedure and testing authorizations, and insurance appeals is required.
Strong interpersonal and communication skills are required.
Solid computer skills, including proficiency with Microsoft software, are required.
Strong analytical and problem-solving skills and attention to detail are required.

Responsibilities

Serve as 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.
Complete insurance appeals.
Coordinate care with social support services and assist with financial assistance for pharmaceutical and charity care programs.
Act as a liaison between insurance companies and patients by initiating financial counseling before service when coverage or authorization problems are identified.
Elevate the patient experience throughout the care journey.

Desired Qualifications

An associate degree in healthcare or business is preferred.
Two years of experience with pre-certification or prior authorization procedures, advanced medical terminology, reimbursement and regulatory issues, insurance functions and terminology, and use of charity care programs is preferred.
Three years of experience in a healthcare setting with working knowledge of insurance and appeals experience related to denials management is preferred.
Experience with heavy phone work is preferred.
A nationally recognized Revenue Cycle certification is preferred.

Total Rewards

OSF HealthCare is dedicated to provide Mission Partners with a comprehensive and market-competitive total rewards package that includes benefits, compensation, recognition and well-being offerings that focus on the whole person and engage with their current stage of life and career. Click here to learn more about benefits and the total rewards at OSF.

Expected pay for this position is $22.27 - $26.20/hour. Actual pay will be determined by experience, skills and internal equity. This is an Hourly position.

Overview

This job is located in Peoria,IL

M-F 8:30-5

POSITION SUMMARY: The Specialty Services Patient 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 Specialty Services Patient Navigator is dedicated to elevating the patient experience through their care journey.

Qualifications

REQUIRED QUALIFICATIONS: Education: High School Diploma/GED Experience: 1 year experience in healthcare financial services, insurance authorization, insurance verification, appeals, billing, registration or MOA/CMA role. 1 year experience with electronic medical record systems. 1 year experience of reading, analyzing and extracting documentation n 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: Associate degree in healthcare or business Experience: 2 years' experience pre-certification/prior authorization procedures, advanced medical terminology, reimbursement and regulatory issues, insurance functions and terminology, and utilization of charity care programs. 3 years' experience in a healthcare setting with working knowledge of insurance and appeals experience related to denials management. Experience with heavy phone work. Licensure/ Certification: Nationally recognized Revenue Cycle certification.

OSF HealthCare is an Equal Opportunity Employer.

About the Company

OSF HealthCare

Integrated health system operating hospitals

OSF HealthCare is an integrated health system that runs hospitals, clinics, home health and hospice services, nursing education, and digital health offerings. It operates 18 inpatient facilities with 2,141 beds, including the OSF HealthCare Children’s Hospital of Illinois, and OSF OnCall for remote and hospital-at-home care. The organization also manages nursing schools, charitable activities through OSF HealthCare Foundation, and health-care businesses under Pointcore, while driving innovation and investment via OSF Innovation and OSF Ventures. Its goal is to improve community health by coordinating care across inpatient, outpatient, and digital platforms, while supporting Mission Partners and expanding access to care.

Company size: 5,001-10,000
Company stage: Not listed
Total funding: Not listed
Headquarters: Peoria, IL
Founded: 1877

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