PAS Authorization Representative Plastic Surgery Clinic

Banner Health • Phoenix, AZ

1d • Onsite

About The Position

The academic medicine difference. At the center of Banner – University Medicine is patient care, research, and teaching. Join a nationally recognized health care leader and experience the future of medicine today. Banner – University Medical Center Wound Care and Hyperbaric Medicine Clinic is part of the Wound Care & Hyperbaric Medicine Center at Banner – University Medical Center Phoenix. The clinic offers treatment options for patients with complicated, chronic and non-healing wounds. Our multi-disciplinary team, which includes family practice physicians, plastic surgeons, podiatrists, vascular surgeons, general surgeons and orthopedic surgeons, all have advanced training in wound care. Our clinicians have national certification and expertise in caring for patients with wounds. We use a case management model to help patients navigate through the complex health care arena Location: Banner Wound, Plastics, and Trauma Clinic – 1012 E Willetta St, Phoenix, AZ 85006 This is a full time (40 hours/week), day shift position: Monday - Friday, 7:30am-4pm. Perfect for detail oriented, flexible, problem solver with strong authorization experience, customer service skills and ability to multi-task with a positive demeanor. We are a very hard working and competent group. We provide lots of hands on training on a continual basis. Our clinic allows for staff to learn a ton about all aspects of this clinic- clinical, data driven info, etc. 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, several 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 has operations in multiple locations spanning across the Phoenix metropolitan city. 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.

Requirements

• High school diploma/GED is required.
• Requires minimum of three years of experience in healthcare insurance and/or authorizations.
• 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.

Nice To Haves

• Associate’s degree in Business Management or equivalent preferred.
• Certification in CRCR and/or CHAA preferred.
• Additional related education and/or experience preferred.

Responsibilities

• 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.
• 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.
• 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.
• 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.
• 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.
• Performs other related duties as assigned. This may include cross-coverage in other authorization-related areas.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED