Primary City/State:

Arizona, Arizona

Department Name:

Rev Cycle Amb Ptnt Access Svcs

Work Shift:

Day

Job Category:

Revenue Cycle

REMOTE OPPORTUNITY

Banner Health is honored to be recognized by Becker’s Healthcare as one of the TOP 150 places to work in health care for 2024!  This recognition in both 2023 and 2024 reflects Banner Health's investment in team members' professional development, wellness benefits, and continued education. It highlights our commitment to advocating for diversity in the workplace, promoting work-life balance, and boosting employee engagement.

T he Patient Access Services Authorization Representative is responsible for validating authorization requirements and processing authorizations. Reviews and responds to all incoming faxes and communications in a timely manner.  Verifies patients Insurance and accurately inputs this information into MS4 or Cerner system, including documenting the account thoroughly in order to maximize reimbursement and minimize denials/penalties from the payor(s) documentation required by the patient’s insurance plan(s). Must be able to consistently meet monthly individual accuracy and productivity goals as determined by management.

This is an excellent opportunity for a customer obsessed individual, who is self-motivated & dependable. We are looking for an individual with excitement, energy, and engagement in a fast-paced, productivity based environment. As a department we strive to provide great customer service and offer our customers and patients the best possible experience! 

Must have minimum of 3 years of related insurance and/or authorizations experience.

Schedule Details:  

First 4-6 weeks of remote training schedule Monday - Friday 7:00am - 3:30pm AZ TIME.

After training schedule may change to Monday - Friday between 8:00am - 5:30pm AZ TIME.

This is a remote position and you must live in the following states only: AK, AR, AZ, CA, CO, GA, FL, IA, ID, IN, KS, KY, LA, MI, MO, MN, MS, NY, NC, ND, NE, NV, OH, OK, OR, PA, SC, TN, TX, UT, VA, WI, WA, & WY

Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.

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.

Certification for CRCR required within one year of hire.

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 for CHAA is preferred.

Additional related education and/or experience preferred.

EEO Statement:

EEO/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

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