Primary City/State:
Scottsdale, Arizona
Department Name:
FSC-Concussion-BSMS
Work Shift:
Day
Job Category:
Administrative Services
Those who have joined the Banner mission come from all walks of life, united by the common goal: Make health care easier, so life can be better. If changing health care for the better sounds like something you want to be part of, we want to hear from you!
Banner Scottsdale Sports Medicine, a three-story, 80,000-square-foot center, welcomes and serves athletes at all levels, from youth to professionals. Our comprehensive, one-stop destination offers numerous sports medicine services and specialists under one roof, with internationally and nationally renowned sports medicine providers and leaders. Services include orthopedic surgery, primary care sports medicine, concussion care, ambulatory surgery center, physical therapy, medical imaging, performance assessment and training, strength and conditioning, sports nutrition, and sports psychology.
As an Auth Rep on this team, you will be an integral part of the patient's Banner experience looking to provide each person with the best customer service and patient care and will do authorization submission, tracking, obtaining and work comp involvement.
This is a full time, day shift, Mon-Fri 8:00AM-5:00PM, with potential for hybrid remote. You will be working with an amazing team supporting athletic teams in the valley including the PHX Suns, Mercury, DBacks, and with growth within our department and Banner.
Banner Health has been recognized by Becker's Healthcare as one of the 150 top places to work in health care. In addition, we recently made Newsweek's list of America's Greatest Workplaces 2023 for Diversity.
These recognitions reflect Banner Health's investment in team members' professional development, wellness benefits, and continued education. It highlights our commitment to advocating for diversity in the workplace, promoting work-life balance, and boosting employee engagement .
Banner University Medical Group is our nonprofit faculty practice plan associated with the University of Arizona Colleges of Medicine in Phoenix and Tucson. Our 800-plus clinicians provide primary and specialty care to patients at highly ranked Banner - University Medical Centers and dozens of clinics while providing mentorship to more than 700 residents and fellows. Our practice values and encourages the three-part mission of academic medicine: research, education and excellent patient care.
POSITION SUMMARY
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.
CORE FUNCTIONS
1. 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.
2. 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.
3. 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.
4. Documents and maintains records of all referral activity and authorizations.
5. Performs other related duties as assigned. This may include cross-coverage in other areas.
6. 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.
MINIMUM QUALIFICATIONS
High school diploma/GED or equivalent working knowledge.
Must possess effective verbal and written communication skills.
Must be proficient with commonly used office software.
PREFERRED QUALIFICATIONS
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.
EOE/Female/Minority/Disability/Veterans
Our organization supports a drug-free work environment.
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