This can be a remote position if you live in the following states only: AZ
1-2 weeks of in office training in Mesa, AZ
In 2021, Banner Health was awarded the designation of "Top Revenue Cycle Performance for Large Systems" during the Revenue Cycle Excellence Awards held by Crowe, a national public accounting, consulting and finance service company. The Banner Health Revenue Cycle team was selected for this distinguished designation out of 1,400 large hospitals across the country. Join a team recognized for the innovative and effective strategies that have enabled us to achieve excellence in revenue cycle performance.
The Banner Imaging Authorization team is looking for motivated individuals that enjoy working in a fast-paced, high volume department. This department is a part of the Patient Access team and we have opportunities for further education, career growth, and mentorship. The position also enjoys the benefit of working from home.
This PAS Authorization Representative will obtain and complete insurance authorization requests for exams scheduled at Banner Imaging. They will work from a worklist of scheduled exams, verify insurance eligibility/benefits, and request authorization for the exam. Sometimes additional documentation or information is needed and you will provide that to get approval for the exam.
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.
Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Banner Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.
NOTE: The core functions are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbent's immediate manager.
High school diploma/GED or equivalent working knowledge.
Must possess effective verbal and written communication skills.
Must be proficient with commonly used office software.
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.
What might draw you to Banner Health? A great health care career, of course—and a great place to live, no matter what stage of life you’re in. With facilities across the West, there is a health care career for everyone, from big city living in the Phoenix area to friendly small towns in the mountains and plains. As one of the largest nonprofit health systems in the country, Banner Health offers both the stability that comes with success and the possibility of exploring new areas of the country. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages:
Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health.
Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible.
The size, success and growth of our system provide you with the stability and options to pursue your desired career path.
Competitive compensation and comprehensive benefits offer you options to complement your unique needs.