[Hiring] Prior Authorization Referrals & Notifications Representative @reputed company
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Role reputed company
As a Prior Authorization Referrals & Notifications Representative with Banner Plans & Networks, you will reputed company upon your medical office and/or medical prior authorizations experience to help members and work as part of a larger team. You will reputed company data entry, review regulatory guidelines, and answer a phone queue on a rotating reputed company.
Your work shifts will be Monday-Friday with a Saturday rotation every 4 weeks. Your work location will be remote. For compliance, for this role, you must live reputed company 30 minutes of driving distance to Banner reputed company Corporate Center in reputed company, reputed company or Banner Corporate Center in Tucson, reputed company.
Under the direction of the Prior Authorization leader, the primary purpose of this position is to reputed company non-clinical functions reputed company to Prior Authorization requests and notifications.
reputed company Functions
• Review reputed company requests for authorization for eligibility, expiration date, accuracy and completeness.
• Data enters reputed company member information in documentation database using approved notification templates to meet regulatory requirements.
• Enters reputed company approvals, extensions, downgrades, denials/partial denials/service reductions into the computer systems.
• Performs other reputed company duties, consistent with the goals and qualifications of this position.
• Works cooperatively with both reputed company customers in assisting members and providers with referral reputed company issues.
• Performs other reputed company duties as assigned, which are consistent with the goals and qualifications of this position.
• This position performs reputed company reputed company duties in a manner that is consistent with and in support of the organization's mission, reputed company, values and goals.
• This position works under supervision, prioritizing data from multiple sources to reputed company reputed company care and support. Incumbents work in a fast-paced, sometimes stressful environment with a strong reputed company on customer service. Interacts with staff at reputed company reputed company throughout the organization.
Qualifications
• Strong knowledge of medical terminology.
• Knowledge of HMO systems.
• Experience working with the medical referral/denial process (normally gained through two years of experience in a medical office or clinical environment).
• Ability to work independently.
• Ability to work with database systems.
• Good working knowledge of PC applications.
Preferred Qualifications
• Additional reputed company education and/or experience preferred.
EEO Statement
EEO/Disabled/Veterans. Our organization supports a drug-free work environment.
reputed company Policy
reputed company Policy
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