Associate Supervisor Prior Authorization

Banner Health • Mesa, AZ

3d • $22 - $33 • Remote

About The Position

Banner Plans & Networks (BPN) is an integrated network for Medicare and private health plans. Known nationally as an innovative leader, BPN insurance plans and physicians work collaboratively to keep members in optimal health while reducing costs. Supporting our members and vast network of providers is a team of professionals known for innovation, collaboration, and teamwork. If you would like to contribute to this leading-edge work, we invite you to bring your experience and skills to BPN. As a Prior Authorization Associate Supervisor, you will be an important member of the Banner Plans & Networks Team. You will work with team members, plan members, providers, and leaders regarding referrals and referral concerns. You will utilize your prior authorization work history and exemplary customer service skills to communicate with internal and external customers. You will also perform referral audits, complete schedule building, complete other duties assigned by leadership, and assist team members with questions and concerns in their daily work. 2+ years of Prior Authorization experience in a medical setting required. Most work can be done remotely. Emergent needs may arise from time to time that require in office work shifts at the Banner Corporate Offices. This role does require Phoenix, Arizona Metro Area residency. Generally Monday - Friday 8:00 a.m. - 5:00 p.m. with at least one Saturday shift a month required. If this role sounds like the one for you, Apply Today! Banner Plans & Networks (BPN) 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 BPN, 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 This position will coordinate and oversee the Prior Authorization non-clinical staff including, but not limited to scheduling day to day work flow. In addition, this position will participate in prior authorization audits, monitoring, training and development of Prior Authorization Non-Clinical Staff.

Requirements

• High school diploma/GED or equivalent working knowledge and two years of Prior Authorization experience in a medical setting.
• Working knowledge of medical insurance and HIPAA required.
• Excellent interpersonal skills and role modeling of superlative customer service skills.
• Must have excellent organizational, multi-tasking, planning, judgment, and problem-solving skills.
• Strong written, oral and interpersonal skills and the ability to work effectively with senior management, physicians, employees and external agencies as required.
• Experience Microsoft Office applications, including Outlook, Word, Excel and PowerPoint programs.

Nice To Haves

• Previous supervisory experience in a medical office setting preferred.
• Knowledge of Health Plan/Insurance skills is preferred.
• Additional related education and/or experience preferred.

Responsibilities

• Reviews all Health Plan referrals for eligibility, expiration date, accuracy and completeness. Enters and tracks all referrals in the computer system.
• Works cooperatively with both internal and external customers in assisting members and providers with referral related issues. Directs appropriate cases to the Utilization Management staff.
• Supervises human and material resources and work activities in the day-to-day operations of assigned area for Prior Authorization, maintaining performance at a level that meets or exceeds department standards. Organizes, coordinates and oversees non-clinical staff scheduling.
• Coordinates and oversees non-clinical duties to include referral processing, Telephone Monitoring of non-clinical staff, Cerecons audits.
• Maintains compliance with policies and meeting performance standards. Assists staff with handling difficult provider concerns and issues.
• May assist department leader in an administrative capacity.
• Works under general supervision and the guidance of the parameters established by the director and as outlined in the facility/entity documents. Requires the constant exercise of a high degree of independent judgment in response to complex and sensitive issues. Requires decision making, discretion, and use of effective human relations skills. Internal customers may include facility medical staff, physicians, hospital personnel, corporate staff, hospital management, and volunteers. External customers include but are not limited to regulatory/accrediting and licensing agencies, legal entities, state and national databases, other hospitals and the general public.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED