Job Description

Location: Chicago, Illinois Business Unit: Rush Medical Group Hospital: Rush University Medical Center Department: Univ Hepatologists Office Work Type: Full Time (Total FTE between 0.9 and 1.0) Shift: Shift 1 Work Schedule: 8 Hr (8:00:00 AM - 4:30:00 PM) Rush offers exceptional rewards and benefits learn more at our Rush benefits page ( Pay Range: $17.63 - $27.77 per hour Rush salaries are determined by many factors including, but not limited to, education, job-related experience and skills, as well as internal equity and industry specific market data. The pay range for each role reflects Rush's anticipated wage or salary reasonably expected to be offered for the position. Offers may vary depending on the circumstances of each case. Summary: The position is responsible for obtaining complete and accurate patient insurance verification and authorization information in order to facilitate the provision of care and services provide by Home Infusion Solutions (HIS). This includes collection of patient data, processing prior authorizations, and the reimbursement components of HIS. Provide prompt and courteous service to navigators, team members clinical partners, and patients. Exemplifies the Rush mission, vision and values and acts in accordance with Rush policies and procedures. Other information: Required Job Qualifications:

• High School Diploma or equivalent.
• 2 year experience with medical insurance authorization in infusion services or other healthcare profession.
• 1 year experience with PBM & Major medical prior authorizations
• Demonstrates basic knowledge of all technical skills associated with assigned duties
• Good problem solving skills
• Ability to work independently and quickly respond and resolve a wide range of problems.
• Excellent verbal and written communication skills
• Ability to communicate with others in a professional and helpful manner.
• Demonstrates ability to adapt to changing environment.
• Ability to work effectively with others as part of a team.
• Good organizational and time management skills.
• Dependable in attendance and job performance.
• Team player with a positive attitude and work ethic

Preferred Job Qualifications:

• Associate's degree from an accredited college/university
• Healthcare/pharmacy experience desired.
• CPR+ experience

Competencies:

• Computer skills (e.g. Microsoft Office, Windows)
• Copier and Fax machine efficiency
• Other office equipment as necessary

Responsibilities:

1. Obtains insurance verification and prior authorization based on initial patient referral data.
2. Verifies patients' insurance coverage. Recognizes and identifies various types of drugs and the billing requirements associated with them. Familiar with abbreviations, symbols, and equivalents used in clinical communications.
3. Documents and verifies billing procedures, and other pertinent information related to the collection process. Recognizes various plan codes and what drugs are covered under these different plans.
4. Determines patient's drug coverage as major medical or PBM and follow appropriate path to obtain authorization and patient's financial responsibility.
5. Submits appeals for authorization denials.
6. Serves as resource to navigators regarding insurance coverage guidelines.
7. Communicates financial responsibilities and generates patient information packets prior to onset of service.
8. Assists patient's with obtaining manufacturer co-pay assistance when appropriate.
9. Prepares patient Start of Care Checklist with inter-disciplinary coordination.
10. Performs other duties as assigned.

Rush is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics. Rush

Job Tags

Hourly pay, Full time, Work at office, Shift work,

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