What are the responsibilities and job description for the Authorization Representative Bariatric Surgery position at Banner Health?
Primary City/State:
Phoenix, ArizonaDepartment Name:
C/P-Bariatric Surgery-ClinicWork Shift:
DayJob Category:
Administrative ServicesThe future is full of possibilities. At Banner Health, we’re excited about what the future holds for health care. That’s why we’re changing the industry to make the experience the best it can be. If you’re ready to change lives, we want to hear from you.
Banner – University Medicine Obesity and Bariatric Surgery Center offers expert care in the medical and surgical treatment of obesity for adult and adolescent patients. Our multidisciplinary team offers highly personalized service and state of the art care. The foundation of our program is built on providing both group and individualized patient education. Our team has experience with more than 5,000 bariatric surgical patients.
This is a full time day shift position working Monday thru Friday 8am to 4:30pm. Duties: request, track, and obtain pre-authorization from insurance carriers with time allotted for bariatric surgery, appeal insurance companies after prior authorization refusals, assess patient documentation for completeness and accuracy and correspond with surgery schedulers. Previous experience in a clinical setting and insurance knowledge a must with great phone etiquette.
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.
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