Patient Access Services Cva Representative

Primary City/State:

Buckeye, Arizona

Department Name:

Rev Cycle Amb Ptnt Access Svcs

Work Shift:

Day

Job Category:

Revenue Cycle

Remote Opportunity

Great careers are built at Banner Health. We understand that talented health care professionals appreciate having options. We are proud to offer our team members many career and lifestyle choices throughout our network of facilities. Apply today, this could be the perfect opportunity for you.

The Patient Access Services CVA Representative is responsible for processing Ambulatory referrals and authorizations for office visits, in office procedures, surgeries and high dollar injections.

1+ years health insurance/ PAS experience required

Schedule: Monday - Friday 8:00am - 4:30pm AZ Time

This can be a remote position if you live in the following states only: AK, AR, AZ, CA, CO, GA, FL, IA, ID, IN, KS, KY, LA, MI, MO, MN, MS, NY, NC, ND, NE, NV, OH, OK, OR, PA, SC, TN, TX, UT, VA, WI, WA, & WY

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. Collaborates with insurance companies, patients and or clinic staff and is responsible for obtaining and processing all pertinent clinical information needed for the authorization of professional and medical ancillary services. This position is responsible for obtaining insurance benefit details for a vast assortment of service types.
CORE FUNCTIONS
1. Responds to “provider orders” 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. 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. Works independently under regular supervision and follows structured work routines. Works in a fast paced, multi task environment with high volume and immediacy needs requiring independent decision making and sound judgment to prioritize work and ensure appropriateness and timeliness of each patient’s care. This position requires the ability to retain large amounts of changing payor information/knowledge crucial to attaining reimbursement for the services provided. Primary external customers include patients and their families, physician office staff and third-party payors.
MINIMUM QUALIFICATIONS
Requires the knowledge and business skills normally demonstrated by an Associate’s degree in Business Management or equivalent education and/or experience.
Requires a proficiency level typically achieved in 1-2 years as an analyst, auditor, in medical office operations and/or experience in healthcare insurance and billing. 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
Work experience shows the ability to excel in revenue cycle positions and the ability to interpret data from applicable reports. Shows a strong skill set in using revenue cycle and reporting systems, to build, analyze and complete work.

EOE/Female/Minority/Disability/Veterans

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