University of Utah Prior Authorization Representative I in Salt Lake City, Utah
Open Date 01/20/2021
Requisition Number PRN25091B
Job Title Prior Authorization Representative I
Job Grade UGR
FLSA Code Nonexempt
Patient Sensitive Job Code? No
Standard Hours per Week 40
Full Time or Part Time? Full Time
Work Schedule Summary
VP Area U of U Health - Academics
Department 00209 - Univ Medical Billing - Oper
City Salt Lake City, UT
Type of Recruitment External Posting
Pay Rate Range $16.51 - $17.34
Open Until Filled Yes
The Prior Authorization Specialist is responsible to secure outpatient and inpatient accounts by performing insurance verification, obtain benefit information, calculating patient estimates and obtain prior authorization before services are rendered. This position work with physicians, nurses, clinic managers, and financial advocates to resolve issues that arise during the prior authorization process.
This position is considered Category IIA : Not required on campus and has the ability to telework remotely for the duration of the University of Utah’s response to COVID -19. An employee hired into this role will be responsible for providing space, telephone, printing, networking and/or internet capabilities at the telecommute location and agree to the terms of the University of Utah campus and Health Academics COVID -19 Telecommuting Agreement.
1.Contacting insurances (by phone, e-mail and regular mail) for eligibility, benefits, network status and authorization, documenting information.
2.Reviews and summarizes pre-authorization criteria for medical necessity to aid departments with procedure scheduling and/or financial advocate needs.
3.Familiarity with contracts, payer guidelines, and resources to determine appropriate coverage and eligibility.
4.Acts as a liaison between the payer and clinic schedulers/medical support staff
5.Maintaining email resource and internal log and working closely with supervisors and managers.
6.Update patient registration with insurance information.
7.Meets productivity and accuracy expectations of the position.
8.Overtime may be required.
9.Other duties may be required.
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.
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.
1.Previous experience with insurance and prior authorizations.
2.Experience with insurance reimbursement and understanding of policies and benefit information, and the ability to give this information to patients, physicians and office staff.
3.Customer Service experience.
4. ICD / CPT Coding Certification
Type Benefited Staff
Special Instructions Summary
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: email@example.com 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: firstname.lastname@example.org .
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.