Details

Monday – Friday

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.

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 ADTPrelude, Cadence, Epicare, Referrals and Auth/Cert applications.
Ability to navigate and maneuver through multiple web sites.

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.
ICDCPT coding experience.
Outpatient or Radiology prior authorizations experience.

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 possess a strong commitment to improving access to higher education.

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.

Consistent with state and federal law, the University of Utah 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 Title IX ( OEO). More information, including the Director/Title IX Coordinator’s office address, electronic mail address, and telephone number can be located at the: University of Utah Non‑Discrimination page

Online reports may be submitted at https://oeo.utah.edu


https://publicsafety.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.

As per University of Utah policy 5-108: Transfer of Benefits Eligible Staff Members, a new hire to the University of Utah who is still serving a 12 month probationary period will not be hired into another University of Utah job (a transfer) until the successful completion of the probationary period.