As part of our continued commitment to providing a safe and healthy workplace, Phoenix Children’s is officially a mandatory COVID-19 vaccination organization, effective October 1, 2021. All new employees must be fully vaccinated prior to starting employment at Phoenix Children’s. Having a vaccinated workforce is an important step in supporting our mission to provide hope, healing and the best healthcare for the children in our community.
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Position Details

Department: CORP | One Call Patient Access
Category: Patient Financial Services
Location: Telecommuting
Posting #: 670944
Date Posted: 4/28/2022
Employee Type: Regular

Position Summary

This position ensures all inpatient/observation stay authorizations and/or referral numbers are present in the AMPFM system for discharged patients at the Hospital. This position also obtains valid inpatient / observation authorization numbers and/or referral numbers for approved Length of Stay (LOS) and Tier Level of Care (LOC) at point of discharge.

PCH Values

  • Family-Centered care that focuses on the need of the child first and values the family as an important member of the care team
  • Excellence in clinical care, service and communication
  • Collaborative within our institution and with others who share our mission and goals
  • Leadership that set the standard for pediatric health care today and innovations of the future
  • Accountability to our patients, community and each other for providing the best in the most cost-effective way.

Position Duties

  1. Collaborates with all Admitting financial services personnel to ensure that a continuum of performance exists between account activation and final discharge status. Ensures appropriate follow up actions are consistent with departmental standards to find, troubleshoot, and resolve any missing authorizations on discharged patients. Works collaboratively with Admitting management and senior personnel in researching denials that are due to no authorization.
  2. Establishes and maintains a multi-tasking mentality in an effort to produce consistently throughout an eight-hour period each day.
  3. Identifies and conveys service dates from point of presentation to discharge towards third party payors with an emphasis on acquiring accurate authorization numbers.
  4. Identifies and conveys Tier levels of care to all AHCCCS plans, commercial carriers, and out of state plans to secure authorizations for services rendered at PCH.
  5. Obtains retro authorizations when research and discovery produce data absence relative to discharged patient accounts.
  6. Reviews and processes daily discharged patient report to ensure accurate and valid authorization/referral numbers are obtained and posted correctly into the AMPFM benefits and authorization screens.
  7. Updates and denotes account activity on a daily basis for all discharged accounts.
  8. Uses sound judgment and analytical skills to ensure positive financial outcomes on all assigned accounts.
  9. Uses system-generated reports to view, inspect, and resolve accounts as they become available on a daily basis.
  10. Performs miscellaneous job related duties as requested.

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Position Qualifications

Please review the following qualifications and specify whether you meet each of the requirements listed.
Do you meet this requirement?
Education
1. Associates in Business or related field; or equivalent combination of post-education and experience. Required
Do you meet this requirement?
Experience
1. Two years insurance verification experience in an Arizona healthcare facility. Required
2. Experience with Arizona AHCCCS plans, commercial insurance carriers, Federal Section 1011 benefits, out of state managed care and third party payer benefits designs and reimbursement requirements. Preferred
Do you meet this requirement?
Special Skills
1. Experience with CPT and ICD-9 diagnosis coding and HIPAA. Preferred
2. Experience with AMPFM (Eclipsys), EMDEON and web-based insurance verification applications. Preferred
Physical Requirements & Occupational Exposure/Risk Potential
1. Physical Requirement - Climbing Occasionally
2. Physical Requirement - Feeling (sensing textures and temperatures) Occasionally
3. Physical Requirement - Fine Motor Skills (pinching, gripping, etc) Frequently
4. Physical Requirement - Hearing Constantly
5. Physical Requirement - Pushing/pulling Frequently
6. Physical Requirement - Reaching Frequently
7. Physical Requirement - Sitting Constantly
8. Physical Requirement - Standing Constantly
9. Physical Requirement - Stooping/crouching/kneeling/crawling Frequently
10. Physical Requirement - Talking Constantly
11. Physical Requirement - Tasting/smelling Occasionally
12. Physical Requirement - Walking Frequently
13. Physical Requirement - Near Vision Frequently
14. Physical Requirement - Far Vision Frequently
15. Physical Requirement - Color Discrimination Frequently
16. Physical Requirement - Use of keyboard, mouse and/or computer equipment Constantly
17. Physical Requirement - Lift up to 35 pounds without assistance Occasionally
18. Physical Requirement - Lift more than 35 pounds without assistance Occasionally
19. Occupational Exposure/Risk Potential - Inside office environment Applicable
20. Occupational Exposure/Risk Potential - Confined areas Applicable
21. Occupational Exposure/Risk Potential - Extreme noise levels Applicable
internal/external
I have reviewed the qualifications, physical requirements and occupational exposure/risk potential for this position and wish to apply