Top 13 Authorization specialist Jobs in Springfield Il

Patient Access Specialist I
Memorial Health —Springfield, IL
- $16.50 - $24.82 an hour
- Weekends as needed
- Hospital
- HIPAA
- High school diploma or GED
- Prescription drug insurance
4d
Patient Access Specialist - Referral Specialist
Springfield Clinic —Springfield, IL
- $16.86 - $23.60 an hour
- Full-time
- Medical office experience
- HIPAA
- Mid-level
Onboarding IAM - Ent
Connection —Springfield, IL
- $22.28 - $27.85 an hour
- Full-time
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- ERP systems
- Paid time off
Nutrition Care Coordinator
Option Care Enterprises, Inc. —Springfield, IL
- $17.02 - $28.38 an hour
- Full-time
- Remote
- Mid-level
- High school diploma or GED
- Organizational skills
- Health savings account
- Health insurance
Quick Apply
4d

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Bisch & Son Funeral Home —Springfield, IL
Receives incoming telephone calls and assist callers with any questions or comments, direct calls to appropriate team members.
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Nelson Oil Co., INC —Springfield, IL
Manage multi-line phone systems, answer inquiries promptly, and direct calls with professionalism and courtesy.
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Insurance Verification and Prior Auth Specialist
Ohio Gastroenterology Group —Columbus, OH
Responds to patient calls about how out of network insurance is handled and provide patient with letter explaining this if necessary.
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10d
Utilization Management Specialist
ST VINCENT FAMILY SERVICES —Columbus, OH
Associate's Degree required; Bachelor's Degree preferred in Healthcare Administration, Business Administration, Social Work, Public Health, or related field.
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Patient Access Specialist I

Memorial Health -
Springfield, IL

Apply Now

Job Details

Full-time
$16.50 - $24.82 an hour
4 days ago

Benefits

Prescription drug insurance

Qualifications

Customer communication
High school diploma or GED
Healthcare software applications
Negotiation

Full Job Description

Min: USD $16.50/Hr. Max: USD $24.82/Hr. Overview:

The Patient Access Specialist is responsible for coordinating patient entry into hospital and affiliated healthcare services. The position ensures accurate and efficient patient registration while supporting financial, compliance, and customer service functions.

Key Responsibilities

Accurately process patient registration and admission information
Collect and verify patient demographic details and insurance (third-party payer) information
Perform financial collections and explain payment responsibilities
Present and explain required legal, ethical, and compliance documents during registration
Maintain confidentiality and compliance with healthcare regulations
Schedule services such as mammography screenings
Serve as a liaison between ancillary departments and Patient Access Services teams
Provide service in patient care environments while maintaining professionalism and compassion

Knowledge & Compliance Requirements

JCAHO standards
Patient Rights and Responsibilities
HIPAA privacy regulations
HMOs and commercial insurance payers
Departmental policies and procedures

Work Schedule

Shift: Day
Hours: 07:30am - 04:00pm
Weekends: N/A
FTE: 1.0

Qualifications:

Education

High School Diploma required.

Licensure / Certification / Registry

Must successfully complete assigned annual education through Healthcare Business Insights.

Experience

Minimum of one (1) year of business office experience preferred, including:
- Patient Access
- Billing and collections
- Insurance principles and practices
- Accounts receivable
Completion of twelve (12) hours of coursework in a business or healthcare-related field may substitute for business office experience.
Previous Patient Access experience strongly preferred.

Knowledge, Skills, and Abilities

Comprehensive understanding of Patient Access Service functions to support accurate registration and reimbursement processes.
Strong interpersonal and patient relations skills with demonstrated professionalism, tact, and sensitivity when interacting with patients, families, staff, and the public.
Ability to maintain emotional composure and professionalism in fast-paced or high-stress environments.
Proficient computer skills including data entry, electronic documentation, and use of registration software and healthcare systems.
Excellent attention to detail with strong critical thinking and problem-solving abilities.
Effective oral and written communication skills with exceptional customer service focus.
Demonstrated flexibility, sound judgment, and initiative when managing competing priorities.
Ability to work independently while contributing positively to team and organizational goals.
Skilled in patient education, persuasion, and negotiation related to financial and registration processes.
Knowledge of medical terminology, CPT procedural coding, ICD-10-CM diagnosis coding, and hospital billing claims preferred but not required.

Responsibilities:

Job Responsibilities

Completes all steps of pre-registration and registration; verifies patient identity and demographic information through appropriate tools.
Identifies and captures appropriate health insurance benefit eligibility based on contract/regulatory differentiation.
Facilitates appropriate billing of claims and hospital reimbursement.
Obtains and validates proper consent for patient treatment.

Scheduling & Patient Coordination

Schedules patients for Mammography procedures efficiently and effectively according to established protocol, including modality, location, facility capabilities, insurance requirements, type of exam, patient preferences, and urgency.

Patient Education & Financial

Educates patients and others regarding resolution of billing issues, private pay options, collection efforts, coordination of benefits, third-party and governmental payment criteria, insurance coverage, payments, and denials.
May serve as a liaison between external resources and patients on issues requiring SMH involvement.
Coordinates with SMH Patient Financial Services, Utilization Management, physicians, and medical offices to ensure consistent financial documentation and an interdisciplinary approach to patient and organizational needs.
Negotiates with patients and families to collect co-pays and/or deposits at point of service and supports Patient Access Services (POS) collection goals as defined by Revenue Cycle leadership and best practice benchmarks.

Compliance & Regulatory Requirements

Adheres to CMS Conditions of Participation regulations and Section 1154(e) of the Social Security Act regarding delivery, explanation, and acquisition of patient or representative signatures.
Verifies medical necessity and obtains appropriate signature on Advance Beneficiary Notice of Non-Coverage (ABN) per CMS regulations at point of patient access.
Ensures compliance with HIPAA, Joint Commission, CDC, SMH, and all applicable state and federal statutes, providing required literature at all Patient Access Service access points.
Educates patients regarding Advance Directives, Medicare Part D prescription coverage, SMH, Joint Commission, and Illinois Department of Public Health grievance processes as appropriate.
Maintains current knowledge of and compliance with the Illinois Fair Patient Billing Act and Illinois Uninsured Patient Discount Act.

Financial Clearance, Insurance & Authorization

Triages, documents, and initiates referrals to Medicaid vendors and/or financial assistance programs per applicable Illinois laws and SMH procedures.
Identifies and reviews services requiring pre-authorization or pre-certification by Medicare, Medicaid, Commercial, and Managed Care payers to ensure eligibility requirements are met prior to service; communicates with physician offices and uses appropriate technology.
Analyzes rejected account reports from hospital sources, including Non-Patient Access registration departments, to resolve eligibility issues, secure reimbursement, or determine financial assistance eligibility.

Operational Support & Additional Duties

Orients and cross-trains others within assigned area of responsibility as directed by management.
Assists other areas within the unit or department during times of special need or staffing shortages.
May be required to work night or weekend shifts.
May rotate work settings, including patient registration, bedside registration, and other SMH campus environments.
May provide coverage for the SMH Financial Lobby Office.
Develops and maintains comprehensive knowledge of the health system organization and completes all assigned annual organizational education.
Meets expectations for productivity, accuracy, and point-of-service collections.
Attends quarterly department meetings unless absence is approved by management in advance.
Performs pre-registration functions as requested.
Performs other related duties as required or assigned.

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authorization specialist jobs in springfield il

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