Primary City/State:
Phoenix, Arizona
Department Name:
BUMCP Plastic Surgery
Work Shift:
Day
Job Category:
Administrative Services
The academic medicine difference. At the center of Banner – University Medicine is patient care, research, and teaching. Join a nationally recognized health care leader and experience the future of medicine today.
Banner – University Medical Center Wound Care and Hyperbaric Medicine Clinic is part of the Wound Care & Hyperbaric Medicine Center at Banner – University Medical Center Phoenix. The clinic offers treatment options for patients with complicated, chronic and non-healing wounds. Our multi-disciplinary team, which includes family practice physicians, plastic surgeons, podiatrists, vascular surgeons, general surgeons and orthopedic surgeons, all have advanced training in wound care. Our clinicians have national certification and expertise in caring for patients with wounds. We use a case management model to help patients navigate through the complex health care arena
This is a full time (40 hours/week), day shift position: Monday - Friday, 7:30am-4pm. Perfect for detail oriented, flexible, problem solver with strong authorization experience, customer service skills and ability to multi-task with a positive demeanor. We are a very hard working and competent group. We provide lots of hands on training on a continual basis. Our clinic allows for staff to learn a ton about all aspects of this clinic- clinical, data driven info, etc.
University Medical Center Phoenix is a nationally recognized academic medical center. The world-class hospital is focused on coordinated clinical care, expanded research activities and nurturing future generations of highly trained medical professionals. Our commitment to nursing excellence has enabled us to achieve Magnet™ recognition by the American Nurses Credentialing Center. The Phoenix campus, long known for excellent patient care, has over 730 licensed beds, several unique specialty units and is the new home for medical discoveries, thanks to our collaboration with the University of Arizona College of Medicine - Phoenix. Additionally, the campus responsibilities include fully integrated multi-specialty and sub-specialty clinics and has operations in multiple locations spanning across the Phoenix metropolitan city.
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.
EEO Statement:
Our organization supports a drug-free work environment.
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Headquartered in Arizona, Banner Health is one of the largest nonprofit health care systems in the country. The system owns and operates 33 acute-care hospitals, Banner Health Network, Banner – University Medicine, academic and employed physician groups, long-term care centers, outpatient surgery centers and an array of other services; including Banner Urgent Care, family clinics, home care and hospice services, pharmacies and a nursing registry. Banner Health is in six states: Arizona, California, Colorado, Nebraska, Nevada and Wyoming.
