Pre Service Prior Authorization Representative

🔥 1 minute ago

🌵 Arizona – Remote

🌵 Arizona – Remote

💵 $20 - $30 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Banner Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1999

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Banner Health is a leading healthcare system committed to making healthcare easier through comprehensive patient services and resources. They provide a safe place for care with services ranging from emergency and urgent care, imaging, and surgery centers to maternity and hospice care. Banner Health also offers telehealth options to ensure access to healthcare, regardless of location. They support athletes through Banner Orthopedics & Sports Medicine and have been recognized for exceptional patient care. With advanced digital tools, they aim to manage healthcare seamlessly for their patients.

📋 Description

• Obtain and complete insurance authorization requests • Verify insurance benefits and authorization requirements • Verify patient insurance and accurately input information into systems • Thoroughly document accounts to maximize reimbursement and minimize denials or penalties • Meet monthly individual accuracy and productivity goals • Complete authorization initiation requests with payers for all service lines • Validate existing provider-requested authorizations • Complete authorizations for acute and ambulatory visits using submission tools and websites • Provide authorization numbers and patient demographic information to staff, including billing • Explain referral processes to physicians and staff • Maintain records of referral activity and authorizations • Refer encounters for peer review when needed • Respond to provider orders for tests, procedures, and specialty visits • Obtain authorizations for single and recurring visits, including verification of demographics, codes, service dates, and clinical data • Stay current on payer requirements and third-party authorization submission software • Work independently from a remote location and prioritize work to ensure timely patient care • Follow escalation protocols for accounts not meeting authorization standards • Perform cross-coverage and other related authorization duties as assigned

🎯 Requirements

• High school diploma/GED required • Minimum of three years of experience in healthcare insurance and/or authorizations • Business skills and experience in the assigned work area • Knowledge of insurance payers • Knowledge of ICD-10 • Problem-solving skills • Computer experience and ability to work across multiple systems • Advanced abilities with common office, word processing, spreadsheet, and database software • Ability to manage multiple tasks simultaneously with minimal supervision and work independently • Detail-oriented with high productivity and accuracy • Excellent organizational, human relations, and communication skills • Associate’s degree in Business Management preferred • CRCR and/or CHAA certification preferred

🏖️ Benefits

• Opportunities for further education • Career growth and mentorship • Work-from-home benefit • Great Place To Work® certified employer