Job description
Primary City/State:
PHOENIX, ArizonaDepartment Name:
PBD-Bariatric Surgery-ArcadiaWork Shift:
DayJob Category:
Administrative ServicesThe future is full of possibilities. At Banner Health, we’re excited about what the future holds for health care. That’s why we’re changing the industry to make the experience the best it can be. If you’re ready to change lives, we want to hear from you.
Banner Health Center plus - Arcadia is one of our newest facilities, taking a new approach to ambulatory care. It will house multiple services in one convenient location, including: Banner Urgent Care, Banner Imaging, Sports Medicine/Orthopedics, Banner Physical Therapy, Sonora Quest Laboratories and Banner Surgery Center. There will also be several Banner University Medical Group specialty clinics such as endocrinology, pulmonology, pediatric/adolescent behavioral health for medical bariatric services, women’s health, primary care, cardiology, gastroenterology, rheumatology, infusion services, several surgical specialties and neurosciences - as well as the new Center for Normal Pressure Hydrocephalus.
As an Authorization Representative within Bariatric Surgery, you will be responsible for obtaining authorizations for patient services, with a lot of time spent on the phone and computer. This is a fast-paced role that requires the skills to prioritize workload and accurately manage many tasks at once. You will have the opportunity to learn and grow professionally at this brand new facility and work with an engaged team, while making a positive difference in the lives of patients.
This is a full time day shift position working Monday through Friday, 8:00am-4:30pm. Your pay and benefits are important components of your journey at Banner Health. This opportunity includes the option to participate in a variety of health, financial, and security benefits.
University Medical Center Phoenix PBCs Banner - University Medical Center Phoenix is a nationally recognized academic medical center. The world-class hospital is focused on coordinated clinical care, expanded research activities and nurturing future generations of highly trained medical professionals. Our commitment to nursing excellence has enabled us to achieve Magnet™ recognition by the American Nurses Credentialing Center. The Phoenix campus, long known for excellent patient care, has over 730 licensed beds, a number of unique specialty units and is the new home for medical discoveries, thanks to our collaboration with the University of Arizona College of Medicine - Phoenix. Additionally, the campus responsibilities include fully integrated multi-specialty and sub-specialty clinics, and with a new $400 million campus investment, a new patient tower and 2 new clinic buildings will be built. 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.
EOE/Female/Minority/Disability/Veterans
Our organization supports a drug-free work environment.
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