Primary City/State:

Phoenix, Arizona

Department Name:

Utilization Mgmt

Work Shift:

Varied

Job Category:

Administrative Services

Great careers are built at Banner Health. We understand that talented professionals appreciate having options. We are proud to offer our team members many career and lifestyle choices including remote work options. Apply today, this could be the perfect opportunity for you.

This role of Business Support Assistant, is critical to the timely and efficient management of the Utilization Review process to support business needs for the Banner Insurance Division. Delegated lines of business include BUHP AHCCCS/ALTCS, Banner Medicare Advantage (MA) plans, United Healthcare Medicare Advantage. This position requires timely case builds in an Acuity system for contractual and regulatory requirement for UM status determinations to be made in 1 business day. You will complete case builds for Acute (hospital) and Post-Acute (Skilled Nursing Facility, Inpatient Rehab Facility, Long Term Acute Care Hospital) admissions for clinical review. You are responsible for screening incoming faxes, attaching records to cases, managing incoming mail/emails and admission reports, case building, assisting with Peer to Peer requests and Appeals process, verifying Member eligibility and other administrative support and management. This is a remote opportunity with hours of 8:30 AM – 5 PM including alternating weekends.

Banner Health has been recognized by Becker’s Healthcare as one of the 150 top places to work in health care. In addition, we recently made Newsweek’s list of America’s Greatest Workplaces 2023 for Diversity.

These recognitions reflect Banner Health's investment in team members' professional development, wellness benefits, and continued education. It highlights our commitment to advocating for diversity in the workplace, promoting work-life balance, and boosting employee engagement.

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 provides administrative services and assistance requiring occasional discretion and judgment. Coordinates a unique set of processes and/or services for an assigned area such as contracting, claims, sales, recruitment, services or billing.

CORE FUNCTIONS
1. Provides administrative and customer or vendor services in assigned area. This may include performing business support functions and related administrative tasks to support a program or process.

2. Reviews and/or audits documents, forms or invoices for appropriateness/accuracy. Initiates corrective action, as appropriate.

3. Corresponds with customers, patients, potential candidates, and vendors using defined formats and procedures, via verbal, electronic and written communications.

4. Maintains records and/or files for assigned area. Ensures appropriate documentation is timely and accurately entered into departmental application.

5. As assigned, prepares, collates, and distributes various reports in a timely and accurate manner. May complete or handle recurring department projects or one-time projects, as directed by supervisor.

6. May maintain supply inventories by checking stock to determine inventory level, anticipating needed supplies, placing and expediting orders for supplies and verifying receipt of supplies.

7.Works independently under general supervision. Represents the company as a primary point of contact to outside entities such as insurance claimants, patients, service providers, community agencies, vendors, etc.

MINIMUM QUALIFICATIONS

Requires a high school diploma or equivalent education and two or more years administrative work experience in a related area. Employees working at Banner Behavioral Health Hospital must possess an Arizona Fingerprint Clearance Card at the time of hire and maintain the card for the duration of their employment.

Works independently under general supervision. Represents the company as a primary point of contact to outside entities such as insurance claimants, patients, service providers, community agencies, vendors, etc. Must have the ability to follow oral and written directions as they relate to the functions listed above. Must have excellent oral, written and interpersonal communication skills to effectively interact with departmental personnel, assist customers with inquiries, schedule meetings and appointments, as well as, provide assistance with incoming telephone calls and walk-ins. Requires the ability to work effectively with common office software, including spreadsheets and word processing. Must have the ability to organize, prioritize and multi-task workload in a fast paced environment and maintain a professional manner.

PREFERRED QUALIFICATIONS

Additional related education and/or experience preferred.

EOE/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

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