At Banner Health, we understand that talented health care professionals appreciate having options. We are proud to offer our more than 50,000 employees many career and lifestyle choices throughout our network of facilities. The people of Banner Health are focused on delivering excellent care to our patients. In return, we are committed to excellence in personal development for all our employees.
As the Prior Authorization Representative, you will obtain prior authorization for all accounts scheduled by Central Scheduling that require authorization to be in place before patients' procedures. This role supports 17 Arizona facilities. The purpose of receiving prior authorization is to help our patients to the fullest capacity to ensure they are being taken care of. You will leverage your experience in initiating and obtaining prior authorizations and use your medical terminology and familiarity with medical procedures to ensure a great customer experience for our patients.
This is an outstanding opportunity to work remote after training has been completed
Your pay and benefits (Total Rewards) are important components of your Journey at Banner Health. Banner Health offers a variety of benefit plans to help you and your family. We provide health and financial security options so you can focus on being the best at what you do and enjoying your life
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 conducts registration, point of service collections and obtains authorizations and forms needed to maximize reimbursement. Document all facets of the registration process and meet accuracy goals as determined by management. Collect payments and meet regular collection targets as determined by management. Demonstrates the ability to collect payments, to resolve customer issues and provide excellent customer service. Perform financial counseling when appropriate.
CORE FUNCTIONS 1. Performs pre-registration/registration processes, verifies eligibility and obtains authorizations, submits notifications and verifies authorizations for services. Verifies patient's demographics and accurately inputs this information into A/D/T system, including documenting the account thoroughly in order to maximize reimbursement and minimize denials/penalties from the payor(s). Obtains federally/state required information and all consents and documentation required by the patient's insurance plan(s). Must be able to consistently meet monthly individual accuracy goal as determine by management.
2. Verifies and understands insurance benefits, Collects patient responsibility based on estimates at the time of service or during the pre-registration process. As assigned collection attempts may be made at the bedside. Must be able to consistently meet monthly individual collection target as determined by management.
3. May provide financial counseling to patients and their families. Explains company financial policies and provides information as to available resources. Assists patients with applying for Medicaid. Assists patients with completing all financial assistance programs (i.e.: basic financial assistance, enhanced financial assistance, prompt pay discount, loan program).
4. Acts as a liaison between the patient, the billing department, vendors, physician offices and the payor to enhance account receivables performance and meet payment collection goals, resolve outstanding issues and/or patient concerns and maximize service excellence.
5. Communicates with physicians, clinical and hospital staff, nursing and Health Information Management Services to resolve outstanding issues and/or patient concerns. Work to meet the patient's needs in financial services.
6. Consistently meets monthly individual productivity goal as determined by management. Completes daily assignments/work lists, keeps electronic productivity log up to date and inputs information accurately. Identifies opportunities to improve process and practices good teamwork.
7. Provides a variety of patient services and financial services tasks. May be assigned functions such as transporting patients, may precept new hire employees, recapping daily deposits, posting daily deposits or conducting other work assignments of the Patient Financial Services team.
8. Works independently under regular supervision and follows structured work routines. Works in a fast paced, multi task environment with high volume and immediacy needs requiring independent decision making and sound judgment to prioritize work and ensure appropriateness and timeliness of each patient's care. This position requires the ability to retain large amounts of changing payor information/knowledge crucial to attaining reimbursement for the services provided. Primary external customers include patients and their families, physician office staff and third party payors.
High school diploma/GED or equivalent working knowledge.
Requires knowledge of patient financial services, financial, collecting services or insurance industry experience processes normally acquired over one or more years of work experience. Requires the ability to manage multiple tasks simultaneously with minimal supervision and to work independently. Requires strong interpersonal, oral, and written communication skills to effectively interact with a wide range of audiences. Employees working at Banner Behavioral Health Hospital must possess an Arizona Fingerprint Clearance Card at the time of hire and maintain the card for the duration of their employment.
Strong knowledge in the use of common office software, word processing, spreadsheet, and database software are required.
Work experience with the Company's systems and processes is preferred. Previous cash collections experience is preferred.
Additional related education and/or experience preferred.
Internal Number: R23213
About Banner Health
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.