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University of Utah Prior Authorization Rep. in Salt Lake City, Utah

Open Date 08/27/2020

Requisition Number PRN24206B

Job Title Prior Authorization Representative I

Working Title Prior Authorization Rep.

Job Grade UGR

FLSA Code Nonexempt

Patient Sensitive Job Code? No

Standard Hours per Week 40

Full Time or Part Time? Full Time

Shift Day

Work Schedule Summary

M-F

VP Area U of U Health - Academics

Department 01455 - Dermatology Clinical Hpp

Location Campus

City Salt Lake City, UT

Type of Recruitment External Posting

Pay Rate Range $12.02 - $19.22

Close Date

Open Until Filled Yes

Job Summary

Responsible for securing outpatient accounts by performing insurance verification, obtaining benefit information, calculating patient estimates and obtaining prior authorization before services are rendered. This position works with physicians, nurses, clinic managers and financial advocates to resolve issues that arise during the prior authorizations process.

Responsibilities

Verifies insurance eligibility, benefits, network status and creates pre-service liability estimate. Ensures accurate ICD , CPT codes and related medical records are submitted in the authorization request. Secures prior authorizations for outpatient imaging and/ in office scheduled services. Acts as a liaison between the payer and clinic schedulers/medical support staff. Follows up on delayed or denied authorization requests and escalates for resolution. Creates detailed documentation and maintains/stores the authorization paper trail. May work to resolve claims denials related to prior authorization

Work Environment and Level of Frequency typically required

Nearly Continuously: Office environment.

Physical Requirements and Level of Frequency that may be required

Nearly Continuously: Sitting, hearing, listening, talking.

Often: Repetitive hand motion (such as typing), walking.

Seldom: Bending, reaching overhead.

Minimum Qualifications

Two years experience in a health care financial setting or equivalency is required.

Previous experience with medical insurance, prior-authorizations and ICD / CPT Coding experience preferred.

This position is not responsible for providing care to patients.

Applicants must demonstrate the potential ability to perform the essential functions of the job as outlined in the position description.

Preferences

Type Benefited Staff

Special Instructions Summary

Additional Information

The University of Utah is an Affirmative Action/Equal Opportunity employer and is committed to diversity in its workforce. In compliance with applicable federal and state laws, University of Utah policy of equal employment opportunity prohibits discrimination on the basis of race or ethnicity, religion, color, national origin, sex, age, sexual orientation, gender identity/expression, veteran’s status, status as a qualified person with a disability, or genetic information. Individuals from historically underrepresented groups, such as minorities, women, qualified persons with disabilities, and protected veterans are strongly encouraged to apply. Veterans’ preference is extended to qualified applicants, upon request and consistent with University policy and Utah state law.

To inquire about this posting, email: employment@utah.edu or call 801-581-2300. Reasonable accommodations in the application process will be provided to qualified individuals with disabilities. To request an accommodation or for further information about University AA/EO policies, please contact the Office of Equal Opportunity and Affirmative Action, 201 S. Presidents Cr., Rm 135, (801) 581-8365 (V/ TDD ), email: oeo@umail.utah.edu .

The University is a participating employer with Utah Retirement Systems (“URS”). Eligible new hires with prior URS service, may elect to enroll in URS if they make the election before they become eligible for retirement (usually the first day of work). Contact Human Resources at (801) 581-7447 for information. Individuals who previously retired and are receiving monthly retirement benefits from URS are subject to URS’ post-retirement rules and restrictions. Please contact Utah Retirement Systems at (801) 366-7770 or (800) 695-4877 or University Human Resource Management at (801) 581-7447 if you have questions regarding the post-retirement rules.

This position may require the successful completion of a criminal background check and/or drug screen.

The University is a participating employer with Utah Retirement Systems (“URS”). Eligible new hires with prior URS service, may elect to enroll in URS if they make the election before they become eligible for retirement (usually the first day of work). Contact Human Resources at (801) 581-7447 for information. Individuals who previously retired and are receiving monthly retirement benefits from URS are subject to URS’ post-retirement rules and restrictions. Please contact Utah Retirement Systems at (801) 366-7770 or (800) 695-4877 or University Human Resource Management at (801) 581-7447 if you have questions regarding the post-retirement rules.This position may require the successful completion of a criminal background check and/or drug screen.

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