Authorization Representative Stem Cell Transplant
2 weeks ago
**Primary City/State**:
Gilbert, Arizona
**Department Name**:
Bone Marrow Trans Admin-Clinic
**Work Shift**:
Day
**Job Category**:
Administrative Services
**Banner MD Anderson's Stem Cell Transplantation** and Cellular Therapy Center treats a wide variety of cancers, hematologic diseases, and autoimmune disorders. Our advanced cell processing laboratory is dedicated to preparing safe and effective stem cell products for transplantation. In addition to inpatient and outpatient services, the Stem Cell Transplantation and Cellular Therapy Center has a dedicated clinic and infusion center that helps monitor and manage complications of stem cell transplantation, including graft versus host disease.
**Schedule**: Monday - Friday 8am-4:30pm, has the potential to be hybrid remote, but weekly travel to the clinic will be required 1-2 days per week.
Experience innovative technology and exceptional opportunities for growth and development at Banner Health's state-of-the-art hospital Banner Gateway Medical Center. With comprehensive electronic medical records, physician order entry, digital radiography and proprietary advanced patient monitoring, Banner Gateway provides you with the innovative resources you need to provide your patients with the best care possible. Our commitment to nursing excellence has enabled us to achieve Magnet recognition by the American Nurses Credentialing Center. Located near Phoenix in Gilbert, Ariz., Banner Gateway Medical Center offers 286 private rooms, 13 operating suites, a 46-bed emergency department and shares a campus with the Banner MD Anderson Cancer Center. Our WIS and NICU services support an average of 4,000 deliveries per year. Key specialties include oncology, obstetrics, bariatric surgery, emergency and other services that focus on meeting the changing needs of the dynamic and growing community we serve.
Banner MD Anderson Cancer Center Located in Gilbert, Ariz. (the Phoenix Metro area) on the Banner Gateway Campus, the center provides world-class care for oncology patients - both inpatient and outpatient - and has also brought leading oncology programs to the Banner Gateway campus including designation as a Stem Cell Transplant Center of Excellence and comprehensive Head & Neck cancer care. Our capabilities include five linear accelerator vaults, a brachytherapy vault, an advanced diagnostic imaging suite with PET/CT scan, more than 70 infusion bays, a cryopreservation lab and much more. Our inpatient medical oncology unit also incorporates a program that utilizes the electronic surveillance partnership in caring for the patient, where remote nurses have the ability to interact with patients via two-way audio-video to assist the bedside nurse with patient care.
This position is responsible for obtaining and processing all pertinent clinical information needed for the authorization of professional and medical services. The position responds to patient referrals and works insurance companies to pre-certify services based on the patient’s benefit plan.
CORE FUNCTIONS
1. Responds to patient referrals 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. Authorizes and schedules appointments. 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. This position has frequent communications with patients, physicians, staff, and third party payers. The position must work with and understand the concepts of managed health care and be able to prioritize tasks within established guidelines with moderate supervision.
MINIMUM QUALIFICATIONS
High school diploma/GED or equivalent working knowledge.
Must possess effective verbal and written communication skills.
Must be proficient with commonly used office software.
PREFERRED QUALIFICATIONS
One or more years of experience normally gained in a medical office or insurance environment. Previous knowledge of managed care concepts. Working knowledge of medical terminology and ICD9 and CPT codes.
Additional related education and/or experience preferred.
EOE/Female/Minority/Disability/Veterans
Our organization supports a drug-free work environment.
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