What are the responsibilities and job description for the Specialty Services Patient Navigator position at OSF HealthCare?
POSITION SUMMARY: 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:
High School Diploma
2 years of working experience in healthcare financial services, insurance authorization, insurance verification, appeals, billing, registration, or MOA/CMA role.
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 ICD-10 and CPT codes and experience with Electronic Medical Record systems.
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.
PREFERRED QUALIFICATIONS:
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 charity care programs.
Associates Degree in healthcare or business 3 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.
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