This position is responsible for providing personalized coordination, clarification and communication of all administrative aspects of care including patient needs assessments, insurance and authorization verification, registration, maintaining and handling of documentation, and scheduling of appointments. This position partners with the clinical care team to ensure a seamless experience for the patient and their family across the entire continuum of their treatment. This position assists with providing resources to help the patient maintain optimal care. This position performs follow-up tasks identified during the patient needs assessment for management of patients across the healthcare continuum or when the patient is in the continuum and needs additional resource support.
Performs patient intake process, which may include pre-registration/registration. Partners with the clinical care team to determine initial authorizations needed based on the predicted care treatment plan. Obtains patient insurance benefit information for all aspects of the treatment, including, but not limited to, inpatient and outpatient services, prescription drugs, and travel and housing, if necessary. May also answer questions regarding the authorization process and supply information to providers, patients and third party payors.
Acts as a resource for insurance coverage, which may include obtaining authorizations and notifications throughout the patients treatment. Obtains all necessary signatures and documentation required by the patients insurance plan. Accurately and completely documents all information into the patient records system to ensure maximum reimbursement. Monitors and updates information regarding insurance data, authorizations, preferred providers and changes in patients treatment plan. Partners with the clinical care team and insurance provider to ensure continued coverage of patients care and maximum reimbursement and minimized financial impact to the patient.
Provides administrative support in maintaining materials such as documents, proposals, routine correspondence, spreadsheets, composing and preparing routine reports, and maintaining records in a variety of business software and database applications for electronic medical records, billing, data management.
Schedules physician appointments, tests, procedures and surgeries and may provide patient with necessary preparation instructions. Prepares, processes, and manages patient documentation to department database . Acts as a liaison between the patient, billing department, and payor to enhance account receivables, resolve outstanding issues and/or patient concerns.
Optimizes patient experience by using effective customer service. Communicates continually with patients, other departments, referral networks and providers to ensure appropriate plans and protocols are followed. Uses discretion and is attentive to issues of customer confidentiality. Demonstrates skills in pro-active resolution and attempts to resolve scheduling conflicts.
May manage the medical record for the assigned area, including coordination with hospitals, practice offices and other ancillary services to obtain needed records. Responds to patient referral requests for tests, procedures and specialty visits. Follows guidelines and may assist in developing procedures to ensure that medical records are in compliance with all state and federal laws. May also reconcile charge tickets, identifying incomplete tickets, missing charge codes or missing diagnosis codes. Notifies clinical staff as needed.
High school diploma/GED or equivalent working knowledge.
Requires skills and abilities typically attained with three or more years working in a hospital or medical office. Requires knowledge of medical terminology. Must be able to work under minimal supervision and make independent decisions using good judgment. Excellent communication, human relations, attention to detail and organizational skills are required. Must possess highly developed interpersonal relations and process coordination skills.
Requires knowledge of payer contract terms and processes. Requires the ability to perform basic math function and the ability to handle confidential information and sensitive issues. Must be able to work effectively with common office software and hospital software to perform intake and updates to patient medical history in addition to other software used in scheduling and billing.
Additional related education and/or experience preferred.
Internal Number: 254046
About Banner Health
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •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 system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •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. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.