OSF Healthcare Careers

Specialty Services Patient Navigator - INI000160

Hours per week: 40
Status (Benefits): Full-Time
Work Schedule: M-F 8:00-4:30
Location: 200 E Pennsylvania Ave Ste 102, Peoria, IL, United States

200 E Pennsylvania Ave Ste 102, Peoria, IL, United States

Job Description

Description

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 testing, 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 within the Neuroscience Service Line.

Qualifications

REQUIRED QUALIFICATIONS:

 

Minimum education requirement is a High School Diploma in addition to 2 years of working experience in healthcare financial services, insurance authorization, insurance verification, appeals, billing, registration, or MOA/CMA role.

 

Ability to achieve specialty Neurological certification, such as MSCS, Multiple Sclerosis Certification Specialist, within 1 year of hire as appropriate for the specialty served.

 

Ability to achieve nationally recognized ambulatory medical office certification through Litmos Healthcare within 1 year of hire.

 

2 years of working knowledge of the revenue cycle including scheduling, registration, and financial clearance, denials, and appeals processes. 

 

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 pharmaceutical assistance and charity care programs. 

 

2 years of working knowledge of ICD-10 and CPT codes and experience with Electronic Medical Record systems required.

 

Superior interpersonal, communication, and customer service skills and be able to work closely with physicians, clinical teams, patients and their insurance companies in specialty offices.

 

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. 

 

Must be able to work with minimal supervision and understand, interpret, evaluate, and resolve customer service issues.

 

 

 

 

PREFERRED QUALIFICATIONS:

 

Degree in healthcare or business

 

3-5 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.

 

 

 

 

EOE/Minorities/Females/Vet/Disabled

Job seekers will be afforded equal opportunity regardless of their race, ethnicity, veteran status or disability status.

 

Experience the OSF culture and community by clicking here.

 

 

 

Job seekers will be afforded equal opportunity regardless of their race, ethnicity, veteran status or disability status.

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