Intake Prior Authorization Rep

Job Number
209332
Banner Home Care and Hospice
Shift
Day
Department
Banner Home Care and Hospice - HME East Location
Position Type
FT: Full-Time
Street Address
1900 N. Higley Road
City & State
US-AZ-Gilbert
Posting Category
Administrative / Clerical

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Banner Home Medical Equipment at Banner Home Care and Hospice is looking for an experienced HME Intake and Prior Authorization Representative to join their fast growing team in Gilbert, AZ!

 

This is a full time position and must be available to work Tue-Sat, 9am-6pm.

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About Banner Home Care and Hospice
Ranked in the top 25 percent of all home care agencies in the United States, Banner Home Care is the largest nonprofit, free-standing home care agency in Arizona. We provide intermittent health care for patients of all ages in the comfort of their home. Our home care team is experienced, compassionate and professional, and the results prove that Banner Home Care measures better than the national and Arizona average in almost all Medicare Quality Compare patient satisfaction results.

About Banner Hospice
Banner Hospice have been providing comfort care for the past 10 years in the Phoenix Metro area. The goal is to support quality of life, honor the wishes of patients, maintain the dignity of the individual and support the family through their grieving process. Inpatient Home care is also available for respite care and symptom management. The Banner Hospice Team can provide comfort to the patient and family by alleviating symptoms, by providing meaningful help and by creating an environment to develop lasting final memories.

 

Truven-2013
Stage7-2013

About Banner Health
Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices and more, our skilled and compassionate professionals use the latest technology to make health care easier, so life can be better. The many locations, career opportunities, and benefits offered at Banner Health help to make the Banner Journey unique and fulfilling for every employee.

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Job Summary

This position processes internal and external requests and referrals for patient placement, services, and equipment from a centralized call center. Serves as a liaison between local patient care services, equipment providers and physicians, clinics, hospitals, third party payers, and other community agencies to support appropriate patient care.

 

Essential Functions

  • Handles incoming requests for patient placement, referrals for new orders and refills, and/or requests for services. Receives and verifies requests and referrals, initiates insurance verification and gathers all information necessary for pre-certifications, authorizations, and certificates of medical necessity. Ensures that each patient meets admission criteria. Provides on-going follow-up of requests up to, and following, patient discharge.

 

  • Builds referrals using information in patient medical record to provide minimum data necessary to coordinate patient services.

 

  • Provides verbal and written instructions to patients, families, and coordinating resources regarding provision of products and services, reimbursement and patient financial responsibility.

 

  • Performs data entry of patient intake information into computer system. Records insurance information and authorization requirements and notes in the computer systems.

 

  • Coordinates requested services and referrals with service and equipment providers, as appropriate. Coordinates with pharmacy warehouse and clinical staff to ensure product availability and sets delivery expectations between patients and providers.

 

  • Facilitates problem solving with patients, hospitals, providers, referral sources, insurance companies, and clinical staff. Assists in the maintenance and communication of changing payor and referral source information specific to coordination of patient needs.

 

 

Minimum Qualifications

High school diploma/GED or equivalent working knowledge. Requires literacy and basic math skills.

Must have a working knowledge of medical terminology and have familiarity with hospital operations. Must possess excellent organizational and interpersonal skills.

Must be proficient with commonly use office software products and possess the ability to learn new software applications.

Preferred Qualifications

Previous experience in a healthcare setting preferred.

Additional related education and/or experience preferred.