| Primary City/State: Mesa, Arizona Department Name: Work Shift: Day Job Category: Administrative Services Those who have joined the Banner mission come from all walks of life, united by the common goal: Make health care easier, so life can be better. If changing health care for the better sounds like something you want to be part of, we want to hear from you. In this role you will be joining a new and growing team at Banner Health, who handle all of the Prior Authorizations for our Banner Imaging Team . In this role you are responsible for verifying eligibility, verification of covered benefits and obtain medical authorizations prior to the patient's scheduled appointment. You will need to monitor and resolve all prior authorization and benefit verification issues prior to the date of the scheduled exam. You will be required to learn the guidelines of the insurance companies assigned to you. We are in constant communication with the scheduling dept, medical offices, insurance companies and ordering Physicians so excellent customer services skills are a must. Knowledge of medical terminology, CPT and ICD-10 codes is helpful. This is a fast paced, high volume, team orientated position, that works Monday - Friday, 8:30am-5pm Your pay and benefits (Total Rewards) are important components of your Journey at Banner Health. Banner Health offers a variety of benefit plans to help you and your family. We provide health and financial security options so you can focus on being the best at what you do and enjoying your life. POSITION SUMMARY
This position is responsible for obtaining and processing all pertinent clinical information needed for the authorization of professional and medical services. The position responds to patient referrals and works insurance companies to pre-certify services based on the patient's benefit plan.
CORE FUNCTIONS
1. Responds to patient referrals for tests, procedures, and specialty visits. Obtains authorizations required by various payors; including verification of patient demographic information, codes, dates of service, and clinical data. Re-certifies services when necessary.
2. Authorizes and schedules appointments. Answers questions regarding the authorization process and supplies information to physicians, patients, and third party payers. May, depending on department/location, inform patients about necessary preparation for procedure or test.
3. 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 and informs them of eligibility issues. Works with staff and patients regarding denials and appeals.
4. Documents and maintains records of all referral activity and authorizations.
5. Performs other related duties as assigned. This may include cross-coverage in other areas.
6. This position has frequent communications with patients, physicians, staff, and third party payers. The position must work with and understand the concepts of managed health care and be able to prioritize tasks within established guidelines with moderate supervision.
MINIMUM QUALIFICATIONS
High school diploma/GED or equivalent working knowledge.
Must possess effective verbal and written communication skills.
Must be proficient with commonly used office software.
PREFERRED QUALIFICATIONS
One or more years of experience normally gained in a medical office or insurance environment. Previous knowledge of managed care concepts. Working knowledge of medical terminology and ICD9 and CPT codes.
Additional related education and/or experience preferred. |
