Details
Posted: 29-Jul-22
Location: Chandler, Arizona
Salary: Open
Categories:
Operations
Primary City/State:
Chandler, Arizona
Department Name:
Banner Staffing Services-AZ
Work Shift:
Day
Job Category:
Marketing and Communications
Find your path in health care. When you join Banner Staffing Services, you join a team that puts patients first. You???ll make an impact on one of the country???s leading health systems and help make our patients??? lives easier. Apply today.??
The Provider Experience Center is responsible for servicing the Banner Health and Banner University Health Plan provider networks. ??We are a high-volume inbound service center that handles several lines of business including but not limited to the United Health Care Medicare Advantage, Banner Medicare Advantage, Banner University Family Care, and Banner ALTCS plans.?? We assist providers with various types of inquiries related to claims, eligibility, contracting, credentialing and prior authorization status to name a few.?? On average our representatives take anywhere from 50/60 calls per day. We are open Monday thru Friday, from 7:30AM - 5PM. No Weekends Monday ??? Friday. Shift start time can vary between 7:30AM, 8AM, 8:30AM and is based on business need. High call volume center experience relating to insurance benefits and medical claims is necessary for this role.
Banner Staffing Services (BSS) offers Registry/Per Diem opportunities within Banner Health. Registry/Per Diem positions are utilized as needed within our facilities. These positions are great way to start your career with Banner Health. As a BSS team member, you are eligible to apply (at any time) as an internal applicant to any regular opportunities within Banner Health.
As a valued and respected Banner Health team member, you will enjoy:
- Competitive wages
- Paid orientation
- Flexible Schedules (select positions)
- Fewer Shifts Cancelled
- Weekly pay
- 403(b) Pre-tax retirement
- Employee Assistance Program
- Employee wellness program
- Discount Entertainment tickets
- Restaurant/Shopping discounts
- Auto Purchase Plan
Registry/Per Diem positions do not have guaranteed hours and no medical benefits package is offered. Completion of post-offer Occupational Health physical assessment, drug screen and background check (includes; employment, criminal and education) is required.
POSITION SUMMARY
This position provides expertise through daily customer service to physicians and/or staff of Banner Health Network affiliated and non-affiliated providers. The representatives providing customer service to providers serves as a primary resource in complex and/or sensitive cases and other resources necessary to ensure an excellent quality of service. May be assigned to work in a variety of administrative duties relative to supporting the provider community.
CORE FUNCTIONS
1. Receives, documents, researches and responds to provider inquiries and escalated calls following established policies and procedures and compliance guidelines. (Answer, identify, research, document, and respond to a diverse and high volume of inbound and outbound health insurance provider related calls on a daily basis.)
2. Works cohesively with appropriate parties to ensure delivery of outstanding customer service while facilitating timely research and issue resolution, in a positive work environment, that supports the department???s ongoing goals and objectives.
3. Provides timely and accurate information to providers regarding claims, benefits, member out-of-pocket expenses, and payments via telephone or in writing. Verifies adjudicate claim payments independently and in accordance with plan guidelines. Performs analysis and appropriate follow-up while working with many individuals to acquire necessary materials and information, including, but not limited to: physicians, facility staff, professional staff and physicians??? office staff.
4. Identifies and resolves managed care issues concerning claims, contract interpretation, utilization management, eligibility and general operational issues. Serves as a resource for internal and external clients to interpret contract language and resolves contract issues by reviewing and interpreting contract terms.
5. Assists internal departments in resolving provider appeals pertaining to the organization???s physicians, hospitals, and insurance plan contracts. Provides education to physicians and their office staff, hospitals and the organization???s insurance plan administration staff.
6. Works on special projects as assigned.
7. Services inbound and outbound providers and office staff communications for all facilities and/or physician offices in the states in which they operate. Works under limited supervision with various departments and staff to provide for diverse customer service needs for a comprehensive provider network. Makes decisions within structured definitions and defined policy. Work requires the constant exercise of a high degree of independent judgment in response to complex and sensitive provider issues, decision making and discretion. Handles physician inquires and problems within the scope of the job function and keeps supervisors apprised of all issues they occur. Meet quality, quantity, and timeliness standards to achieve individual department performance goals as defined within the department guidelines and compliance standards. In addition, the incumbent must have excellent verbal and written communication skills, determine work priorities, and is expected to accomplish all tasks with minimal supervision and instruction.
MINIMUM QUALIFICATIONS
High school diploma/GED or equivalent working knowledge.
Must have substantial previous related work experience in healthcare services, with three to four years of experience in a high volume service center or managed care environment. Ability to multitask between inbound calls, searching the database or resource tools for correct and timely information, and maintain a professional demeanor at all times.
Must have excellent communication skills, both verbal and written, while maintaining a positive and helpful attitude with customers. Must demonstrate an ability to meet deadlines in a multi-functional task environment. Requires excellent organizational skills and operational knowledge working with work processing, spreadsheets, data entry, fax machines, and other computer related skills. Must have the ability to acquire and utilize a sound knowledge of the company???s provider information systems, as well as, fundamental knowledge of the organization???s expectations. Must, at all times, maintain efficiency and timeliness in all daily activities. Must be able to establish daily work priorities and work efficiently to contribute to the successful overall provider experience.
PREFERRED QUALIFICATIONS
Experience with a strong knowledge of business and/or healthcare as normally obtained through the completion of an associate???s degree. The knowledge of medical claims typically acquired over one to two years of work experience in medical claims adjudication, contract interpretations, billing and coding, and medical terminology.
Additional related education and/or experience preferred.
