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Job Overview
Location
Arizona, USA
Job Type
Full-time
Category
Product Management
Date Posted
November 12, 2025
Full Job Description
đź“‹ Description
- • Serve as the critical link between Banner Health’s clinical teams and external payers, ensuring every authorization, denial, and concurrent review is processed with speed and accuracy. You will own the end-to-end workflow—from the moment a patient is admitted to post-discharge follow-up—safeguarding millions in net revenue while keeping care delivery seamless.
- • Process and package clinical documentation for in-house patients, then route it to insurance carriers before deadlines. You will extract the minimum necessary data from the electronic medical record, build concise clinical packets, and submit them through payer portals or secure fax, tracking each case until a determination is returned.
- • Enter authorizations and concurrent denials directly into Epic and the UM module, ensuring that utilization review RNs have real-time visibility into payer decisions. Your meticulous data entry prevents downstream billing delays and supports accurate length-of-stay forecasting.
- • Own the centralized phone queue Monday–Friday, 8:30 a.m.–5:00 p.m. AZ time. You will answer calls from case managers, payers, and physician advisors, triage requests, and escalate urgent issues—all while maintaining a quiet, HIPAA-compliant home workspace.
- • Verify insurance benefits and medical-necessity criteria at intake, flag high-risk cases for early clinical review, and document authorization requirements in the patient’s financial file. This proactive step reduces avoidable denials and accelerates discharge planning.
- • Build and maintain payer grids, fee schedules, and policy updates in SharePoint so that every team member references the same, current information. When payers change rules, you will alert the UM and billing teams within 24 hours.
- • Coordinate with Patient Financial Services and the Central Billing Office to resolve stalled claims. You will re-submit corrected authorizations, append clinical addendums, and track appeal deadlines, ensuring Banner Health captures every allowable dollar.
- • Generate daily dashboards that show pending authorizations, denial trends, and turnaround-time metrics. Your insights will guide staffing decisions and identify process gaps before they impact revenue.
- • Participate in Lean and Kaizen events aimed at reducing fax volume, shortening payer response times, and automating routine tasks. Your frontline experience will shape future-state workflows and technology enhancements.
- • Foster collaborative relationships with external case managers, UR nurses, and medical directors at major payers. Your professional demeanor and clinical accuracy position Banner Health as a trusted partner, leading to faster approvals and fewer retrospective audits.
- • Adhere strictly to CMS, state, and Banner Health compliance standards. You will complete annual HIPAA, fraud-waste-abuse, and cultural-competency training, and you will escalate any suspected compliance issues to the Corporate Responsibility Hotline.
- • Contribute to a culture of continuous improvement by mentoring new hires, sharing payer-specific tips during huddles, and celebrating team wins. Banner Health’s recent Great Place to Work certification reflects our commitment to your growth and well-being.
🎯 Requirements
- • Minimum of 3 years of hands-on experience in hospital workflow—Patient Access, Scheduling, Health Unit Coordinator, or similar—clearly documented on your resume
- • Demonstrated ability to work independently in a secure, distraction-free remote environment between 8:30 a.m.–5:00 p.m. AZ time, Monday–Friday
- • Proficiency with medical terminology and electronic health record systems (Epic preferred); accurate data-entry speed of at least 45 WPM
- • Strong organizational and time-management skills with a proven track record of meeting tight payer deadlines and managing high-volume caseloads
- • Excellent verbal and written communication skills for effective collaboration with clinical teams, payers, and patients’ families
- • Bilingual (English/Spanish) preferred for select assignments
🏖️ Benefits
- • Competitive hourly pay range of $21.01–$31.51 based on location, education, and experience, with bi-weekly direct deposit
- • Comprehensive medical, dental, and vision coverage starting day one, plus HSA and FSA options
- • 401(k) with generous company match and immediate vesting to secure your financial future
- • Paid time off, paid holidays, and flexible scheduling options to support work-life balance
- • Access to Banner Health’s award-winning wellness programs, employee assistance plan, and tuition reimbursement for career advancement
Skills & Technologies
Remote
About Banner Health
Banner Health is a nonprofit health system operating hospitals, clinics, and specialized care facilities across six western U.S. states. Founded in 1999 through mergers, it delivers acute care, behavioral health, emergency, rehabilitation, and long-term services. The organization also runs Banner Health Network, Medicare Advantage plans, and conducts clinical research.
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