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OSF HealthCare

Post-Acute Prior Authorization Specialist

OSF HealthCare, Peoria, Illinois, us, 61639

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Post-Acute Prior Authorization Specialist

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OSF HealthCare .

Total Rewards "Your life - our Mission". OSF HealthCare offers a comprehensive, market‑competitive rewards package that includes benefits, compensation, recognition, and well‑being offerings focused on the whole person.

Pay Expected pay: $21.72 – $25.55 per hour. Actual pay will be determined by experience, skills, and internal equity. This is an hourly position.

Overview Full Remote Near OSF Location.

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. They work collaboratively with the case management team, hospital care team, community partners, and insurance companies to ensure patient care needs are met regarding post-acute care prior authorizations. The specialist 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, and identifies medical criteria for post-acute care from chart review to develop 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 a 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.

Proficiency in communicating complex information sensitively in hospital environments.

Ability to work independently and prioritize tasks within established timeframes.

Interpersonal skills to facilitate communication with team members, department staff, external personnel, and patients/families with courtesy and tact.

Preferred Qualifications

Bachelor’s degree in a healthcare field.

Ability to interact with health‑care team members and external personnel to exchange patient care data.

Typing speed of at least 35 words per minute.

Organizational skills in coordinating services with co‑workers and other departments/services.

Calm, rational response to stressful situations and cooperation to facilitate integrated patient care that exceeds expectations.

Strong analytical and problem‑solving skills with attention to detail.

Seniority Level Entry level

Employment Type Full-time

Job Function Other

Industries Hospitals and Health Care

Equal Opportunity Statement OSF HealthCare is an Equal Opportunity Employer.

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