Under the direction of the NOA Senior Mgr, the primary purpose of this position is to process all Notices of Action (NOA) and Notices of Non-Medical Coverage (NOMNC) for services accurately and in a timely manner.
Review all UAHP denials for eligibility, expiration date, accuracy and completeness.
Writes all member information in AHCCCS/SNP approved NOA/NOMNC templates to meet regulatory requirements.
Enters all denials/partial denials/service reductions into the computer systems.
Performs other related duties, consistent with the goals and qualifications of this position.
Works cooperatively with both internal and external customers in assisting members and providers with referral related issues.
Performs other related duties as assigned, which are consistent with the goals and qualifications of this position.
This position performs all related duties in a manner that is consistent with and in support of the organization's mission, vision, values and goals.
Required for successful performance in this position is strong knowledge of medical terminology, knowledge of HMO systems and experience working with the medical referral/denial process. This knowledge is normally gained through two years of experience in medical office or clinical environment.
Ability to work independently is required, as is the ability to work with data base systems and good working knowledge of PC applications.
Additional related education and/or experience preferred.
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.