Sorry, this job is no longer accepting applications. See below for more jobs that match what you’re looking for!

Health Plan LPN Notice Of Action

Expired Job

Banner Health Mesa , AZ 85205

Posted 5 months ago

Health care is constantly changing, and at Banner Health, we are at the front of that change. We are leading health care to make the experience the best it can be. We want to change the lives of those in our care and the people who choose to take on this challenge. If changing health care for the better sounds like something you want to be part of, we want to hear from you.

The Notice of Action (NOA) department is completely compliance driven, in that AHCCCS (Medicaid) and Medicare create the rules of how this department is to be operated. The LPN will assist with writing and sending denial letters to update members through the benefit process. They work very closely within our prior authorization department, and will have no direct patient contact.

Requirement:

Active unrestricted AZ LPN license permitting work in the State of Arizona.

Schedule:

Monday-Friday; 8:00AM-5:00PM

In office, and opportunities for on-call rotation

Location:

Banner Corporate Center-Mesa
525 West Brown RD.

Mesa, AZ 85201

Your pay and benefits (Total Rewards) are important components of your Journey at Banner Health. Banner Health offers a variety of benefit plans to help you and your family. We provide health and financial security options so you can focus on being the best at what you do and enjoying your life

  • --

About University Physicians Health Plans

The University of Arizona Health Plans (UAHP) manage a variety of health plans. Our mission is to advance health and wellness through education, research and patient care.

About Banner Health

Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices and more, our skilled and compassionate professionals use the latest technology to make health care easier, so life can be better. The many locations, career opportunities, and benefits offered at Banner Health help to make the Banner Journey unique and fulfilling for every employee.

  • --

Job Summary

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.

Essential Functions

  • Reviews 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.

  • Call rotation for the health plan, as well as departmental call rotation for holidays.

  • Meets internal and external customer service expectations regarding duties and professionalism.

  • 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.

Minimum Qualifications

Current, unrestricted AZ LPN license permitting work in the State of Arizona. A minimum of three years experience in an acute care setting. At least two years of experience in prior authorization or utilization management, knowledge of insurance, managed care principles, and community facilities and resources.

Proficient on a computer (PC) with Microsoft Office Products. Ability to work with data bases/programs, such as IDX and ability to work independently, with analytical, problem solving, decision making, concurrent and retrospective data management skills are necessary. Working knowledge of medical terminology and coding (ICD-9, CPT-4) is required.

Preferred Qualifications

Experience specific to ICU/Med. Surg. and knowledge of Arizona Health Care Cost Containment System (AHCCCS) and Centers for Medicare and Medicaid Services (CMS) regulations preferred.Knowledge of AHCCCS, CMS and regulatory requirements and working knowledge of clinical criteria such as Milliman Care Guidelines is preferred.

Additional related education and/or experience preferred.


upload resume icon
See if you are a match!

See how well your resume matches up to this job - upload your resume now.

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Notice Of Action Coordinator

Banner Health

Posted 1 week ago

VIEW JOBS 1/5/2019 12:00:00 AM 2019-04-05T00:00 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. Our team has come together with the common goal: Make health care easier, so life can be better. The future of health care starts here. If you're ready to change lives, we want to hear from you. Apply today. The Notice of Action (NOA) department is completely compliance driven, in that AHCCCS (Medicaid) and Medicare create the rules of how this department is to be operated. The Notice of Action Coordinator will assist with writing and sending denial letters to update members through the benefit process. They work very closely within our prior authorization department, and will have no direct patient contact. Schedule: Monday-Friday; 8:00AM-5:00PM Rotation of Saturday coverage, every 3rd week (8:00AM-5:00PM) In office This position will be located at: Banner Health Corporate 525 W Brown RD Mesa, AZ 85201 Your pay and benefits (Total Rewards) are important components of your Journey at Banner Health. Banner Health offers a variety of benefit plans to help you and your family. We provide health and financial security options so you can focus on being the best at what you do and enjoying your life. * -- About University Physicians Health Plans The University of Arizona Health Plans (UAHP) manage a variety of health plans. Our mission is to advance health and wellness through education, research and patient care. About Banner Health Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices and more, our skilled and compassionate professionals use the latest technology to make health care easier, so life can be better. The many locations, career opportunities, and benefits offered at Banner Health help to make the Banner Journey unique and fulfilling for every employee. * -- Job Summary 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. Essential Functions 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. Minimum Qualifications 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. Preferred Qualifications Additional related education and/or experience preferred. Banner Health Mesa AZ

Health Plan LPN Notice Of Action

Expired Job

Banner Health