Prior Authorization Specialist

1 week ago


Chicago, Illinois, United States Rush Specialty Hospital Full time
Rush Specialty Hospital Job Opportunity

We are seeking a highly skilled and results-driven Prior Authorization Specialist to join our team at Rush Specialty Hospital. As a key member of our team, you will play a vital role in managing the pre-certification and prior authorization of referrals scheduled for admission to our hospital.

Key Responsibilities:
  • Initiate and complete patient authorizations in a timely manner
  • Obtain timely authorization of all patients requiring pre-certification and maintain a high conversion percentage
  • Ensure compliance with all policies governing commercial pre-certification and authorization to minimize financial risk
  • Develop and maintain relationships with payors to increase and stabilize conversion, as well as generate referrals locally and regionally
  • Collaborate with Business Development and Case Management teams to ensure a smooth hand-off of patients and maintain continuity in patient care plans
Requirements:
  • At least two (2) years of direct experience in third-party reimbursement
  • Must be a Registered Nurse (RN) or Licensed Practical Nurse (LPN)
  • Preferred experience working with Excel and databases
  • Must live in the Central Standard Time zone to be considered for this position
What We Offer:
  • An extensive and thorough orientation program
  • A Monday through Friday schedule with six (6) paid holidays
  • Paid Time Off (PTO) and Extended Illness Days (EID)
  • Health, Dental, and Vision insurance; Life insurance; Prescription coverage
  • A 401(k) retirement plan with company match
  • Short and Long Term Disability
  • Personal and Family Medical Leave

Rush Specialty Hospital is committed to having a workforce that reflects diversity at all levels and is an equal opportunity employer. Qualified applicants are considered for employment without regard to race, color, religion, national origin, citizenship, age, sex, sexual orientation, gender identity, marital status, ancestry, physical or mental disability, veteran status, or any other characteristic protected under applicable law.



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