Specialty Services Patient Navigator

OSF HealthCare; Peoria (IL); On-site; USD 30,000 - 35,000; Full time

Job summary

OSF HealthCare in Peoria, IL seeks a Specialty Services Patient Navigator to guide patients through labs, procedures, and visits, coordinating authorizations and referrals across the health system.

The role includes coordinating insurance pre-certifications, appeals, and financial counseling, with emphasis on improving the patient journey and addressing coverage issues before services.

Qualifications

• Education: High School Diploma or GED required.
• Experience: 1 year in healthcare financial services, insurance verification, approvals, billing, registration or related MOA/CMA role.
• 1 year experience with electronic medical record systems.
• Strong interpersonal and communication skills; proficient with Microsoft Office; detail-oriented and analytical.

Responsibilities

• Serve as dedicated liaison to support patients through labs, visits, procedures, radiology, referrals, and authorizations.
• Initiate and coordinate medical insurance pre-certifications, authorizations, and appeals as needed.
• Provide financial counseling and assist with charity care programs and financial assistance when applicable.

Skills

Interpersonal communication

Microsoft Office

Analytical skills

Attention to detail

Education

High School Diploma/GED

Associate degree (preferred)

Job description

Total Rewards

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 $21.72 - $25.55/hour. Actual pay will be determined by experience, skills and internal equity. This is an Hourly position.

Overview

This job is located in Peoria,IL

M-F 8:30-5

POSITION SUMMARY

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.

Qualifications

REQUIRED QUALIFICATIONS

Education: High School Diploma/GED Experience: 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. Other Skills/ Knowledge: 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.

PREFERRED QUALIFICATIONS

Education: Associate degree in healthcare or business Experience: 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. Licensure/ Certification: Nationally recognized Revenue Cycle certification.

OSF HealthCare is an Equal Opportunity Employer.