What are the responsibilities and job description for the Supervisor, HP Referrals position at Banner Health?
Primary City/State:
Phoenix, ArizonaDepartment Name:
Prior AuthorizationWork Shift:
DayJob Category:
Administrative ServicesFind your path in health care. We want to change the lives of those in our care – and the people who choose to take on this challenge. If you’re ready to change lives, we want to hear from you .
The notifications team processes approval, denial and provider faxes for all lines of business. The supervisor assists in creating and updating desktop procedures, reviewing timecards, acts as a information resource, performs productivity audits, and any tasks as needed.
The future is full of possibilities. At Banner Health, we’re excited about what the future holds for health care. That’s why we’re changing the industry to make the experience the best it can be. If you’re ready to change lives, we want to hear from you .
This position is remote with a schedule of Monday-Friday 8:00 AM-5:00 PM.
This position is remote with some travel to Phoenix office.
Banner Health Network (BHN) 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 BHN, 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 Denials non-clinical staff including, but not limited to scheduling day to day work flow. In addition, this position will participate in Denials audits, monitoring, training and development of Denial Non-Clinical Staff.
CORE FUNCTIONS
1. Reviews all Health Plan denials eligibility, expiration date, accuracy and completeness. Processes denials into the computer system and performs denial audits.
2. Works cooperatively with both internal and external customers in assisting members and providers with referral related issues. Provides a high quality of customer service to both internal and external customers.
3. Maintains compliance with policies and meeting performance standards.
4. Coordinates and oversees non-clinical duties to include Denial/NOA processing, monitoring of clinical and non-clinical NOAs to include logging the NOA as a permanent record
5. Assists staff with handling difficult provider concerns and issues. Schedules day to day work flow and provides input to Manager on performance reviews.
6. Organizes, coordinates and oversees NOA staff scheduling and mailing deadlines for compliance.
7. May assists department leader in administrative capacity as directed.
8. Works independently under general supervision. Has freedom to determine how to best accomplish functions within established procedures. Confers with manager on any unusual situations. This position ensures the prompt and effective communication with constituent stakeholders including physicians, hospitals, health plan members and managed care organizations, as well as employees at all levels in the organization
MINIMUM QUALIFICATIONS
High school diploma/GED or equivalent working knowledge.
Must possess skills and abilities normally attained with 2 years of related experience in a medical setting. Must be proficient and have working knowledge in area of service. Must demonstrate effective communication, team building, human relations and organization skills. Must have previous knowledge or Health Plan/medical insurance practices. Requires knowledge of HIPAA.
Must be familiar with commonly used office software and/or have the ability to learn new software applications if necessary.
PREFERRED QUALIFICATIONS
Previous supervisory experience in a medical office setting preferred.
Additional related education and/or experience preferred.
