University of Utah Prior Authorization Specialist I in Salt Lake City, Utah


Open Date 07/09/2018

Requisition Number PRN17728B

Job Title Prior Authorization Representative I

Working Title Prior Authorization Specialist I

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

Monday-Friday 8:00 am -4:30 pm

VP Area U of U Health - Academics

Department 00209 - Univ Medical Billing - Oper

Location Other

City Salt Lake City, UT

Type of Recruitment External Posting

Pay Rate Range $16.19-17.00 per hour

Close Date

Open Until Filled Yes

Job Summary

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.


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.Overtime may be required.

8.Other duties may be required.

Minimum Qualifications

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

Previous experience with medical insurance, prior-authorizations andICD/CPTCoding 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/CPTCoding Certification

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: 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: .

The University is a participating employer with Utah Retirement Systems (“URS”). To be eligible for retirement contributions, you must be hired into a benefit-eligible position. Certain new hires are automatically assigned to the URS retirement plan and other employees with prior URS service, may elect to enroll in the URS within 30 days of hire. Regardless of whether they are hired into a benefit-eligible position or not, individuals who previously retired and are receiving monthly retirement benefits from URS must notify the Benefits Department upon hire. Please contact Utah Retirement Systems at (801)366-7770 or (800)695-4877 or the University’s Benefits Department at (801)581-7447 for information.

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