Authorization Representative Greeley

Banner Health•Denver, CO

2d•$18 - $27•Hybrid

About The Position

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. At Banner Medical Group, you'll have the opportunity to perform a critical role in the community where you practice. Banner Medical Group provides both primary and specialty care throughout the communities in which Banner Health operates. We do this in a variety of settings - from smaller group practices like our Banner Health Clinics in Colorado and Wyoming, to large multi-specialty Banner Health Centers in the metropolitan Phoenix area. We currently have more than 1,000 physicians and more than 3,500 total employees in our group and are seeking others to enhance our ability to deliver our nonprofit mission of providing excellent patient care.

Requirements

High school diploma/GED or equivalent working knowledge.
Must possess effective verbal and written communication skills.
Must be proficient with commonly used office software.

Nice To Haves

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.

Responsibilities

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.
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.
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.
Documents and maintains records of all referral activity and authorizations.
Performs other related duties as assigned. This may include cross-coverage in other areas.
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.