Insurance Prior Authorization Jobs in Illinois (NOW HIRING)

Christie Clinic's department of Behavioral Health is seeking a full-time Medical Assistant/Insurance Specialist at the Windsor clinic in Champaign between the hours of Monday-Friday 8:00am-5:00pm, with no night or weekend requirements. Duties include obtaining insurance prior authorization for ordered treatments, medications, and referrals, scheduling office appointments, and direct patient care in the clinic office setting.

JOB DUTIES: (This list may not include all of the duties assigned.)

• Obtain insurance prior authorization for appointments, medications, and ordered therapy, as required, via web based, telephone, fax, and/or written communication.
• Accurately obtain and update necessary information to process and submit prior authorization requests.
• Proficiently utilize third party payer portals, insurance payer portals, or governmental payer portals to process submission of prior authorization requests.
• Update insurance information, authorization status, and any other pertinent information in the patient's medical record.
• Advocate for patients/providers by processing referrals and scheduling exams within the requested/designated timeframe.
• Serves as the liaison between patient, ordering provider, office, and insurance carrier to facilitate timely scheduling of recommended exams.
• Respond to and coordinate follow-up regarding insurance denials, appeals, and retro-authorization attempts in cooperations with ordering provider/office.
• Correspond regarding authorization status updates with appropriate personnel (for example, schedulers, ordering offices, etc.)
• Review and respond to the EMR work list and in basket messages per department standard work.
• Provide insurance guidance to team members or providers. Demonstrate understanding of insurance requirements.
• Maintain an organized work area.
• Maintain up to date information regarding changes to insurance requirements in the electronic medical record and individual carrier updates.
• Answer phones and triage phone calls as appropriate.
• Act in the absence of a receptionist by checking patients in for appointments, answering phones, scheduling appointments, etc.
• Schedule patient appointments.
• Transcribe physician orders.
• Obtain patient vital signs, weight, and height.
• Prepare exam and treatment rooms with necessary supplies/equipment prior to appointment.
• Clean and restock rooms.
• Perform chart preparation according to department standards.
• Maintain and update patient medical record upon visit including allergies, medications, past medical history, etc.
• Review and respond to the EMR work lists.in baskets per department standard work.
• Assist in patient education as appropriate for scope/licensure.
• Communicate professionally and effectively with all providers, team members, patients, and external agencies.
• Obtain necessary supplies to maintain department operations.
• Contribute to safe and therapeutic patient relationships and care environment.
• Use age appropriate, therapeutic communication
• Perform related work as required.

REQUIRED QUALIFICATIONS:

• High School Diploma or equivalent

PREFERRED QUALIFICATIONS:

• Experience in a medical office setting
• Graduation from an accredited program for certified nursing assistants or certified medical assistants
• Prior experience with health insurance system
• Non-Violent Crisis Intervention Training
• Pediatrics experience

CERTIFICATE/LICENSE:

• BLS Certification

TYPICAL PHYSICAL DEMANDS:

Demands include prolonged sitting, standing, walking, bending, stooping, stretching and lifting up to 75 pounds. Hearing within, or correctable to, normal range, vision correctable to 20/20 and manual dexterity is also required.

TYPICAL WORKING CONDITIONS:

Work is performed in a clinical office setting with possible exposure to communicable diseases, toxic substances, hazardous waste, bodily fluids and other waste common to a health care environment. Requirements may include working irregular hours.

PAY AND BENEFITS:

The estimated pay range for this position is exclusive of fringe benefits and potential bonuses. Final offers are based on various factors, including skill set, experience, qualifications, and other job-related criteria.

We also offer a substantial benefits package, including:

• Paid Time Off (Vacation, Sick, Personal, Holiday, Birthday)
• Dependent Care Flexible Spending Account
• 401k Plan
• Medical Flexible Spending Account
• Health Insurance
• Group Term Life Insurance
• Dental Insurance
• Identity Theft Protection
• Vision Insurance
• Long Term Disability
• Accidental Death & Dismemberment Insurance