Prior Authorization Specialist

OSF HealthCare

Posted 3 months ago

Full Time

Peoria, Illinois

Hybrid

Smart Summary

Responsibilities

The specialist is responsible for receiving and initiating medication authorization requests. They collaborate with patients, providers, and insurance companies to ensure patient care needs are met regarding precertification.

Qualifications

You have a High School diploma/GED and at least one year of experience in a clinical or medical insurance setting. You also possess excellent interpersonal and communication skills, along with solid computer proficiency, especially with Microsoft software.

Must Have Skills for ATS

Microsoft software

EPIC CMA

MOA

CNA

CPhT

Job Description

Total Rewards

"Your life - our Mission"

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 $18.80 - $22.12/hour. Actual pay will be determined by experience, skills and internal equity. This is an Hourly position.


Overview

Hybrid Position- must reside within 60 miles of OSF Peoria location. Initial training onsite in Peoria for 2-4 weeks.

POSITION SUMMARY:

​The Prior Authorization Specialist in the OSF Medication Prior Authorization department is responsible for receiving new medication authorization requests and accurately initiating these requests. Works collaboratively with patients, caregivers, providers, pharmacies, office staff and insurance companies to ensure that patient care needs are met regarding medication prior authorizations. The Specialist impacts the clinical and financial risk to the organization when obtaining insurance precertification or authorization.


Qualifications

REQUIRED QUALIFICATIONS:

Education: High School/GED

Experience: 1 year of experience in a clinical environment or medical insurance setting.

Other skills/knowledge: Excellent interpersonal and communication skills. Solid computer skills, including proficiency with Microsoft software.

PREFERRED QUALIFICATIONS: ​

Demonstrated knowledge of patient care activities as well as provider practice office. Electronic health record experience, especially the ambulatory module within EPIC CMA, MOA, or the equivalent (CNA, CPhT, or similar).

Other requirements/information: Accurate typing speed of at least 35 words per minute. Proven organizational skills in coordinating services with co-workers and other departments/services. Responds to stressful situations in a calm, rational manner and cooperates with all to facilitate integrated patient care that exceeds expectation.

OSF HealthCare is an Equal Opportunity Employer.

OSF HealthCare

OSF HealthCare is an integrated health system founded by The Sisters of the Third Order of St. Francis and headquartered in Peoria, Illinois. The system includes 18 inpatient facilities encompassing 16 licensed hospitals, two of which operate dual campuses in separate communities. Among these hospitals, 10 are acute care facilities, five are critical access hospitals and one is a continuing care facility. OSF has 2,141 licensed beds throughout Illinois and Michigan. OSF employs more than 27,000 Mission Partners across 170+ locations. These include OSF HealthCare Children’s Hospital of Illinois, the third largest pediatric hospital in the state, and OSF OnCall, its digital health operating entity that offers hospital-at-home care. In addition, OSF operates two colleges of nursing; OSF Home Care Services, an extensive network of home health and hospice services; Pointcore, Inc., which is composed of health care-related businesses; and OSF HealthCare Foundation, the philanthropic arm of the organization. Advances in health care transformation take place through OSF Innovation as well as OSF Ventures, which provides investment capital for promising health care innovation startups. OSF HealthCare has been recognized by Fortune as one of the most innovative companies in the country. OSF consistently earns recognition for showing dedication to the well-being of its Mission Partners: •America’s Best-in-State Employers | Forbes Magazine | 2018-2026 •150 Top Places to Work in Healthcare | Becker’s Healthcare | 2019, 2022-2025 •Best Employers for Women | Forbes Magazine | 2020 OSF HealthCare is an Equal Opportunity Employer (EOE). By engaging with this page, you acknowledge and agree to follow our social media terms of use, which you can find here: https://www.osfhealthcare.org/patients-visitors/terms-conditions/social-terms
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