University of Utah
Prior Authorization Representative I - Dermatology
University of Utah, Salt Lake City, Utah, United States, 84106
Details
Increase your chances of reaching the interview stage by reading the complete job description and applying promptly.Open Date
05/29/2024
Requisition Number
PRN38698B
Job Title
Prior Authorization Representative I
Working Title
Prior Authorization Representative I - Dermatology
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
VP Area
U of U Health - Academics
Department
01455 - Dermatology Clinical Hpp
Location
Other
City
Salt Lake City, UT
Type of Recruitment
External Posting
Pay Rate Range
19.27 - 25.49
Close Date
Open Until Filled
Yes
Job Summary
This position is responsible to secure 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. This position is not responsible for providing care to patients.
This position is eligible for work from home and/or hybrid work options. Might be required to work onsite during training period.
Responsibilities
Essential Functions
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 the prior authorization.
Knowledge / Skills / Abilities
Basic knowledge of accounting, word processing and spreadsheets.
Demonstrated critical thinking and ability to analyze information and problem solve.
Demonstrated professional verbal/written communication skills.
Ability to work independently within a team setting.
Ability to adapt to a dynamic work environment.
Demonstrated ability to prioritize and manage a large workload in stressful situations.
Ability to multitask.
Familiarity with human anatomy and medical terminology.
Demonstrated ability to complete work with a high level of detail and accuracy.
Ability to meet process time standards.
Ability to provide professional and courteous service in all interactions with internal and external customers.
Ability to navigate through various hospital software applications, including Epic ADT /Prelude, Cadence, Epicare, Referrals and Auth/Cert applications.
Ability to navigate and maneuver through multiple web sites.
Minimum Qualifications
Required
Two years of experience in a health care financial setting, or equivalency (one year of education can be substituted for two years of related work experience).
Preferred
Previous experience with medical insurance and prior-authorizations.
ICD / CPT coding experience.
Outpatient or Radiology prior authorizations experience.
Preferences
Type
Benefited Staff
Special Instructions Summary
Additional Information
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 of Utah values candidates who have experience working in settings with students and patients from all backgrounds and possess a strong commitment to improving access to higher education and quality healthcare for historically underrepresented students and patients.
All qualified individuals are strongly encouraged to apply. Veterans’ preference is extended to qualified applicants, upon request and consistent with University policy and Utah state law. Upon request, reasonable accommodations in the application process will be provided to individuals with disabilities.
The University of Utah is an Affirmative Action/Equal Opportunity employer and does not discriminate based upon race, ethnicity, color, religion, national origin, age, disability, sex, sexual orientation, gender, gender identity, gender expression, pregnancy, pregnancy-related conditions, genetic information, or protected veteran’s status. The University does not discriminate on the basis of sex in the education program or activity that it operates, as required by Title IX and 34 CFR part 106. The requirement not to discriminate in education programs or activities extends to admission and employment. Inquiries about the application of Title IX and its regulations may be referred to the Title IX Coordinator, to the Department of Education, Office for Civil Rights, or both.
To request a reasonable accommodation for a disability or if you or someone you know has experienced discrimination or sexual misconduct including sexual harassment, you may contact the Director/Title IX Coordinator in the Office of Equal Opportunity and Affirmative Action ( OEO /AA). More information, including the Director/Title IX Coordinator’s office address, electronic mail address, and telephone number can be located at: https://www.utah.edu/nondiscrimination/
Online reports may be submitted at oeo.utah.edu
https://safety.utah.edu/safetyreport This report includes statistics about criminal offenses, hate crimes, arrests and referrals for disciplinary action, and Violence Against Women Act offenses. They also provide information about safety and security-related services offered by the University of Utah. A paper copy can be obtained by request at the Department of Public Safety located at 1658 East 500 South.
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Increase your chances of reaching the interview stage by reading the complete job description and applying promptly.Open Date
05/29/2024
Requisition Number
PRN38698B
Job Title
Prior Authorization Representative I
Working Title
Prior Authorization Representative I - Dermatology
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
VP Area
U of U Health - Academics
Department
01455 - Dermatology Clinical Hpp
Location
Other
City
Salt Lake City, UT
Type of Recruitment
External Posting
Pay Rate Range
19.27 - 25.49
Close Date
Open Until Filled
Yes
Job Summary
This position is responsible to secure 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. This position is not responsible for providing care to patients.
This position is eligible for work from home and/or hybrid work options. Might be required to work onsite during training period.
Responsibilities
Essential Functions
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 the prior authorization.
Knowledge / Skills / Abilities
Basic knowledge of accounting, word processing and spreadsheets.
Demonstrated critical thinking and ability to analyze information and problem solve.
Demonstrated professional verbal/written communication skills.
Ability to work independently within a team setting.
Ability to adapt to a dynamic work environment.
Demonstrated ability to prioritize and manage a large workload in stressful situations.
Ability to multitask.
Familiarity with human anatomy and medical terminology.
Demonstrated ability to complete work with a high level of detail and accuracy.
Ability to meet process time standards.
Ability to provide professional and courteous service in all interactions with internal and external customers.
Ability to navigate through various hospital software applications, including Epic ADT /Prelude, Cadence, Epicare, Referrals and Auth/Cert applications.
Ability to navigate and maneuver through multiple web sites.
Minimum Qualifications
Required
Two years of experience in a health care financial setting, or equivalency (one year of education can be substituted for two years of related work experience).
Preferred
Previous experience with medical insurance and prior-authorizations.
ICD / CPT coding experience.
Outpatient or Radiology prior authorizations experience.
Preferences
Type
Benefited Staff
Special Instructions Summary
Additional Information
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 of Utah values candidates who have experience working in settings with students and patients from all backgrounds and possess a strong commitment to improving access to higher education and quality healthcare for historically underrepresented students and patients.
All qualified individuals are strongly encouraged to apply. Veterans’ preference is extended to qualified applicants, upon request and consistent with University policy and Utah state law. Upon request, reasonable accommodations in the application process will be provided to individuals with disabilities.
The University of Utah is an Affirmative Action/Equal Opportunity employer and does not discriminate based upon race, ethnicity, color, religion, national origin, age, disability, sex, sexual orientation, gender, gender identity, gender expression, pregnancy, pregnancy-related conditions, genetic information, or protected veteran’s status. The University does not discriminate on the basis of sex in the education program or activity that it operates, as required by Title IX and 34 CFR part 106. The requirement not to discriminate in education programs or activities extends to admission and employment. Inquiries about the application of Title IX and its regulations may be referred to the Title IX Coordinator, to the Department of Education, Office for Civil Rights, or both.
To request a reasonable accommodation for a disability or if you or someone you know has experienced discrimination or sexual misconduct including sexual harassment, you may contact the Director/Title IX Coordinator in the Office of Equal Opportunity and Affirmative Action ( OEO /AA). More information, including the Director/Title IX Coordinator’s office address, electronic mail address, and telephone number can be located at: https://www.utah.edu/nondiscrimination/
Online reports may be submitted at oeo.utah.edu
https://safety.utah.edu/safetyreport This report includes statistics about criminal offenses, hate crimes, arrests and referrals for disciplinary action, and Violence Against Women Act offenses. They also provide information about safety and security-related services offered by the University of Utah. A paper copy can be obtained by request at the Department of Public Safety located at 1658 East 500 South.
#J-18808-Ljbffr