Specialty Services Patient Navigator

OSF HealthCare • Peoria, IL

19h • Onsite

About The Position

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.

Requirements

• High School Diploma/GED
• 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 in patient medical charts to complete pre-certifications, pharmaceutical authorizations, procedure and testing authorizations, and the insurance appeals.
• 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.

Nice To Haves

• Associate degree in healthcare or business
• 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.
• Nationally recognized Revenue Cycle certification.

Responsibilities

• 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.
• Assist with financial assistance for pharmaceutical and charity care programs.
• Act as a liaison between insurance companies and patients by initiating financial counseling prior to service when coverage/authorization problems are identified.
• Elevate the patient experience through their care journey.

Benefits

• Comprehensive and market-competitive total rewards package
• Benefits, compensation, recognition and well-being offerings
• Focus on the whole person and engage with their current stage of life and career

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED