Patient Access Services Authorization Representative
About The Position
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. 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.
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.
- Must have 2 or more years of healthcare insurance authorizations (Imaging, Surgery, Pharmacy, or other procedures) is a must and 1+ years of health insurance experience.
- Great customer service stills and problem-solving skills are needed.
- Must have basic knowledge of CPT and ICD Codes and have reliable internet (NO WIFI, Ethernet Connection only) and a quiet work area/home office.
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.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
5,001-10,000 employees
