PAS Pre Service Prior Authorization Representative

Department Name:

Centralized Pre-Regist-Corp

Work Shift:

Day Job Category:

Revenue Cycle Great options and opportunities. 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. Apply today!

Our remote authorization team is looking for motivated individuals that enjoy working in a fast-paced, high-volume department. This department is a part of the Patient Access team and we have opportunities for further education, career growth, and mentorship. The position also enjoys the benefit of working from home.

The PAS Authorization Representative will obtain and complete insurance authorization requests. They are responsible for verifying and understands insurance benefits, validating authorization requirements. Verifies patients Insurance and accurately inputs this information into our systems, including documenting the account thoroughly in order to maximize reimbursement and minimize denials/penalties from the payor(s) documentation required by the patient’s insurance plan(s). Must be able to consistently meet monthly individual accuracy and productivity goals as determined by management.

Full Time Hours are Monday
- Friday 8:30AM-5:00 PM AZ Time3 years of procedure auth/referral experience or surgery scheduler needed.

Knowledge of Insurance Payers;
Knowledge of ICD 10;
Problem solving skills also needed. Self-Starter who can work independently. Patient oriented with great communication skills and Is eager to be the solution in any circumstance. Computer experience and working out of multiple systems needed.

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…