Patient Access Services Authorization Representative
Primary City/State:
Phoenix, ArizonaDepartment Name:
Work Shift:
DayJob Category:
Revenue CycleExplore and excel. If you’re looking to leverage your abilities to make a real difference – and real change in the health care industry – you belong at Banner Staffing Services. Apply today.
Banner Staffing Services (BSS) offers Registry/Per Diem opportunities within Banner Health. Registry/Per Diem positions are utilized as needed within our facilities. These positions are great way to start your career with Banner Health. As a BSS team member, you are eligible to apply (at any time) as an internal applicant to any regular opportunities within Banner Health.
As a valued and respected Banner Health team member, you will enjoy:
Competitive wages
Paid orientation
Flexible Schedules (select positions)
Fewer Shifts Cancelled
Weekly pay
403(b) Pre-tax retirement
Employee Assistance Program
Employee wellness program
Discount Entertainment tickets
Restaurant/Shopping discounts
Auto Purchase Plan
Completion of post-offer Occupational Health physical assessment, drug screen and background check (includes; employment, criminal and education) is required.
Must be located in AZ, CA, CO, NE, NV, WY
This position is 100% remote!
Must have 2 or more years of healthcare insurance authorizations (Imaging, Surgery, Pharmacy, or other procedures) is a must and 1+ years of health insurance experience. Great customer service stills and problem-solving skills are needed.
Must have basic knowledge of CPT and ICD Codes and have reliable internet (NO WIFI, Ethernet Connection only) and a quiet work area/home office.
Must be able to complete a 4-week paid training (Days and hours will vary)
Schedule: Monday - Friday 8:00am to 5:30pm Arizona Time; this position does not offer benefits.
POSITION SUMMARY
This position performs insurance verification and authorization functions that support Patient Access Services and ensures compliance with both department standards and billing requirements. This position requires the ability to retain large amounts of changing payor information/knowledge crucial to attaining reimbursement for the services provided. This position is expected to reduce authorization-related initial denials/write-offs.
CORE FUNCTIONS
1. Uses department procedures and new hire training to accurately complete authorization initiation requests with payers for all service lines and validates existing authorizations requested by providers. Completes authorization initiation for acute and ambulatory visits. Utilizes standard authorization submission tools, websites, and documents authorization updates in Host systems.
2. Provides necessary information regarding authorization numbers and patient demographic information to appropriate staff, including billing. Provides information about the referral process to physician and staff. Documents and maintains records of all referral activity and authorizations in appropriate Host fields. Refers encounters for peer review to substantiate ordered procedures.
3. Responds to “provider orders” for tests, procedures, and specialty visits. Obtains authorizations for single and/or reoccurring visits required by various payers, including verification of patient demographic information, codes, dates of service, and clinical data. Representatives will stay current on payor requirements and utilization of third-party authorization submission software to complete authorizations.
4. Works independently from a remote location and follows structured work routines. Works in a fast-paced environment requiring independent decision making and sound judgment to prioritize work and ensure appropriateness and timeliness of each patient’s care.
5. Follows escalation protocols for accounts not meeting authorization standards by working with the ordering provider, scheduling departments, PAS leaders, and administrative groups for resolution in all acute, ambulatory, Banner Imaging, and Oncology service lines.
6. Performs other related duties as assigned. This may include cross-coverage in other authorization-related areas.
MINIMUM QUALIFICATIONS
High school diploma/GED is required.
Requires minimum of three years of experience in healthcare insurance and/or authorizations.
Business skills and experience in the assigned work area are required. Must be detail oriented. Must be able to maintain high productivity standard with minimal errors. Advanced abilities in the use of common office software, word processing, spreadsheet, and database software are required. Requires the ability to manage multiple tasks simultaneously with minimal supervision and to work independently. Excellent organizational skills, human relations, and communication skills required.
PREFERRED QUALIFICATIONS
Associate’s degree in Business Management or equivalent preferred.
Certification in CRCR and/or CHAA preferred.
Additional related education and/or experience preferred.
EEO Statement:
EEO/Disabled/Veterans
Our organization supports a drug-free work environment.
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