Insurance Representative Home Care

Primary City/State: Mesa, Arizona Department Name: Banner Staffing Services-AZ Work Shift: Day Job Category: Revenue Cycle Great careers start with great training. 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 team members. Apply today. Join the fastest growing Post-Acute agency in Arizona. This department works as a collaborative team with business development and operations to ensure that we bring the best care to patients that we service. We are a integrative health care system that has a robust post-acute continuum of care that sets us apart from the competition. As a Banner Home Care Insurance Representative, you will work in a high volume environment with a centralized insurance verification team. You will handle front-end insurance eligibility, benefits and authorizations for home health referrals. We are centralized to handle referrals from Phoenix area, Payson, Tucson, Loveland CO and Greeley CO. This position is REMOTE scheduled Saturdays and Sundays 8:30am-5:30pm MTN time. Banner Staffing Services (BSS) offers Registry/Per Diem opportunities within Banner Health. Registry/Per Diem positions are utilized as needed within our facilities. These positions are great way to start your career with Banner Health. As a BSS team member, you are eligible to apply (at any time) as an internal applicant to any regular opportunities within Banner Health. When working Per Diem you must work at least 2 shifts a month. As a valued and respected Banner Health team member, you will enjoy: Competitive wages Paid orientation Flexible Schedules (select positions) Fewer Shifts Cancelled Weekly pay 403(b) Pre-tax retirement Employee Assistance Program Employee wellness program Discount Entertainment tickets Restaurant/Shopping discounts Auto Purchase Plan Registry/Per Diem positions do not have guaranteed hours and no medical benefits package is offered. Completion of post-offer Occupational Health physical assessment, drug screen and background check (includes: employment, criminal and education) are required. 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 remote location and follows structured work routines. Works in a fast-paced environment requiring independent decision making and sound judgment to prioritize work and ensure appropriateness and timeliness of each patient's care. 5. Follows escalation protocols for accounts not meeting authorization standards by working with the ordering provider, scheduling departments, PAS leaders, and administrative groups for resolution in all acute, ambulatory, Banner Imaging, and Oncology service lines. 6. Performs other related duties as assigned. This may include cross-coverage in other authorization-related areas. MINIMUM QUALIFICATIONS High school diploma/GED is required. Requires minimum of three years of experience in healthcare insurance and/or authorizations. Certification for CRCR required within one year of hire. Business skills and experience in the assigned work area are required. Must be detail oriented. Must be able to maintain high productivity standard with minimal errors. Advanced abilities in the use of common office software, word processing, spreadsheet, and database software are required. Requires the ability to manage multiple tasks simultaneously with minimal supervision and to work independently. Excellent organizational skills, human relations, and communication skills required. PREFERRED QUALIFICATIONS Associate's degree in Business Management or equivalent preferred. Certification for CHAA is preferred. Additional related education and/or experience preferred. EOE/Female/Minority/Disability/Veterans Our organization supports a drug-free work environment. Privacy Policy