Patient Access Services Authorization Representative Remote

Banner Health; Phoenix, Northern (AZ, KY); Hybrid; USD 52,000 - 64,000; Full time

Job summary

Banner Health is seeking a remote Insurance Verification and Authorization Specialist to support Patient Access Services. The role requires 3+ years in healthcare insurance authorizations, solid referral processes knowledge, and attention to detail.

You will work from a quiet home office, with reliable internet and a Monday–Friday schedule in Arizona time. The position supports multiple service lines, including imaging, surgery, and pharmacy, and aims to reduce authorization-related denials.

Qualifications

• 3+ years of experience in healthcare insurance and/or authorizations.
• Strong organizational and communication skills are required.
• Detail oriented with the ability to manage multiple tasks.

Responsibilities

• Performs insurance verification and authorization tasks to support Patient Access Services.
• Maintains records of referrals and authorizations in host systems.
• Communicates authorization numbers and demographic information to staff and billing.

Skills

Excellent organizational skills

Strong communication skills

Detail oriented

Education

High school diploma/GED

Associate's degree in Business Management or equivalent (preferred)

Job description

Primary City/State: Phoenix, Arizona. Department Name: BIS PAS. Work Shift: Day. Job Category: Revenue Cycle.

Good health care is key to a good life. We're certified as a Great Place To Work® and are looking for professionals to help us make Banner Health the best place to work and receive care. You have a place in the health care industry. There's more to health care than IV bags and trauma rooms. We support all staff members as they find the path that is right for them. If you're looking to leverage your abilities - you belong at Banner Health.

This position is 100% remote! 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. Schedule: Monday - Friday 8:00am to 5:30pm Arizona Time

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.

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.

CORE FUNCTIONS

1. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. Performs other related duties as assigned. This may include cross-coverage in other authorization-related areas.

MINIMUM QUALIFICATIONS

• 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.

PREFERRED QUALIFICATIONS

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

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