The 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.
We are a high paced department who work great together as a family. We manage all prior authorization requests, United HealthCare Medicare Advantage and our Banner Medicare Advantage lines of business. Our non-clinical and clinical staff works closely together to ensure that our members are taken care of in a timely manner.
Your pay and benefits are important components of your journey at Banner Health. Banner Health offers a variety of benefits to help you and your family. We provide health and financial security options so you can focus on being the best at what you do and enjoying your life.
Banner Health Network (BHN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BHN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs.
POSITION SUMMARY Under the direction of the Prior Authorization leader, the primary purpose of this position is to perform non-clinical functions related to Prior Authorization requests and notifications.
CORE FUNCTIONS 1. Review all requests for authorization for eligibility, expiration date, accuracy and completeness.
2. Data enters all member information in documentation data base. Uses approved notification templates to meet regulatory requirements.
3. Enters all approvals, extensions, downgrades, denials/partial denials/service reductions into the computer systems.
4. Performs other related duties, consistent with the goals and qualifications of this position.
5. Works cooperatively with both internal and external customers in assisting members and providers with referral related issues.
6. Performs other related duties as assigned, which are consistent with the goals and qualifications of this position.
7. This position performs all related duties in a manner that is consistent with and in support of the organization's mission, vision, values and goals.
8. This position works under supervision, prioritizing data from multiple sources to provide quality care and support. Incumbents work in a fast-paced, sometimes stressful environment with a strong focus on customer service. Interacts with staff at all levels throughout the organization.
Required for successful performance in this position is strong knowledge of medical terminology, knowledge of HMO systems and experience working with the medical referral/denial process. This knowledge is normally gained through two years of experience in medical office or clinical environment.
Ability to work independently is required, as is the ability to work with data base systems and good working knowledge of PC applications.
Additional related education and/or experience preferred.
What might draw you to Banner Health? A great health care career, of course—and a great place to live, no matter what stage of life you’re in. With facilities across the West, there is a health care career for everyone, from big city living in the Phoenix area to friendly small towns in the mountains and plains. As one of the largest nonprofit health systems in the country, Banner Health offers both the stability that comes with success and the possibility of exploring new areas of the country. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages:
Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health.
Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible.
The size, success and growth of our system provide you with the stability and options to pursue your desired career path.
Competitive compensation and comprehensive benefits offer you options to complement your unique needs.