Prior Authorization Representative I

2 weeks ago

Salt Lake, Utah, United States University of Utah Health Full time

Overview

This position is primarily remote work, but candidate must reside within the state of Utah for this one.

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, diversity, integrity, quality and trust that are integral to our mission. EO/AA

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.

Top candidates will also have some prior working experience in Prior Authorizations.

Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes.

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 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.

Qualifications

Qualifications Required

  • Two years of experience in a health care financial setting, or the equivalency.

Qualifications (Preferred)

Preferred

  • Previous experience with medical insurance and prior-authorizations.
  • ICD/CPT coding experience.
  • Outpatient or Radiology prior authorizations experience.

Working Conditions and Physical Demands

Employee must be able to meet the following requirements with or without an accommodation.

  • This is a sedentary position that may exert up to 10 pounds and may lift, carry, push, pull, or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions.

Physical Requirements

Listening, Sitting, Speaking

Multi-lingual Candidates Welcomed

To inquire about this posting, email:

EEO Statement

University of Utah Health Hospitals and Clinics, a part of The University of Utah, values candidates who have experience working in settings with students from diverse backgrounds and possess a strong commitment to improving access to higher education for historically underrepresented students.

Individuals from historically underrepresented groups, such as minorities, women, qualified persons with disabilities and protected veterans are 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.

University of Utah Health Hospitals and Clinics, a part of 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, please contact the University of Utah Health Hospitals and Clinics Human Resources office at 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:

Sherrie Hayashi

Director/ Title IX Coordinator

Office of Equal Opportunity and Affirmative Action (OEO/AA)

383 University Street, Level 1 OEO Suite

Salt Lake City, UT 84112

Online reports may be submitted

For more 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 Hospitals and Clinics Human Resources at 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 or or Hospitals and Clinics Human Resources at 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.

Requisition Number 68156

Reg/Temp Regular

Employment Type Full-Time

Shift Day

Work Schedule Day shift 08:00- 16:30

Clinical/Non-Clinical Status Non-Clinical

Location Name Business Services Building

Workplace Set Up Remote

City SALT LAKE CITY

State UT

Department COR ISC 10D PAT ACCESS NOVA

Category Finance/Accounting

Workplace Set Up Remote

  • Materials Handler I

    2 weeks ago

    Salt Lake, Utah, United States bioMerieux Inc. Full time

    Materials Handler I - Day (A Shift) Location: Salt Lake City, UT, United StatesPosition Type: Unfixed TermJob Function: Supply Chain Share: share to e-mailApply Now >A family-owned company, bioMerieux has grown to become a world leader in the field of in vitro diagnostics. For almost 60 years and across the world, we have imagined and developed innovative...

  • Field Sales Representative

    4 weeks ago

    Salt Lake, Utah, United States Proclinical Full time

    Field Sales Representative - Permanent - OnsiteProclinical Staffing is seeking a Field Sales Representative to join a cutting-edge laboratory. This is a permanent role located in Salt Lake City, UT.Skills & Requirements:Bachelors degree in Chemistry, Materials Science, Chemical Engineering or other technical field.2+ years experience in capital equipment...

  • Field Sales Representative

    1 month ago

    Salt Lake, Utah, United States Proclinical Full time

    Field Sales Representative - Permanent - OnsiteProclinical Staffing is seeking a Field Sales Representative to join a cutting-edge laboratory. This is a permanent role located in Salt Lake City, UT.Skills & Requirements:Bachelors degree in Chemistry, Materials Science, Chemical Engineering or other technical field.2+ years experience in capital equipment...

  • Patient Support Service Representative

    2 weeks ago

    Salt Lake, Utah, United States HCA Full time

    IntroductionThis is a as needed position.Do you have the PRN career opportunities as a Patient Support Service Representative you want with your current employer? We have an exciting opportunity for you to join St. Mark's Hospital which is part of the nation's leading provider of healthcare services, HCA Healthcare.BenefitsSt. Mark's Hospital, offers a total...

  • Patient Support Service Representative

    4 weeks ago

    Salt Lake, Utah, United States HCA Healthcare Inc Full time

    Description IntroductionThis is a as needed position.Do you have the PRN career opportunities as a Patient Support Service Representative you want with your current employer? We have an exciting opportunity for you to join St. Mark's Hospital which is part of the nation's leading provider of healthcare services, HCA Healthcare.BenefitsSt. Mark's Hospital,...

  • Patient Support Service Representative

    1 month ago

    Salt Lake, Utah, United States HCA Healthcare Inc Full time

    Description IntroductionThis is a as needed position.Do you have the PRN career opportunities as a Patient Support Service Representative you want with your current employer? We have an exciting opportunity for you to join St. Mark's Hospital which is part of the nation's leading provider of healthcare services, HCA Healthcare.BenefitsSt. Mark's Hospital,...

  • Patient Support Service Representative

    1 month ago

    Salt Lake, Utah, United States HCA Healthcare Full time

    Description IntroductionThis is a as needed position.Do you have the PRN career opportunities as a Patient Support Service Representative you want with your current employer? We have an exciting opportunity for you to join St. Marks Hospital which is part of the nations leading provider of healthcare services, HCA Healthcare.BenefitsSt. Marks Hospital,...

  • Junior IT Operations Engineer

    2 weeks ago

    Salt Lake, Utah, United States WebBank Full time

    WebBank (the "Bank") is a Utah chartered Industrial Bank headquartered in Salt Lake City, Utah. As "The Bank Behind the Brand", WebBank is a national issuer of consumer and small business credit products through Strategic Partner (Brand) platforms, which include retailers, manufacturers, finance companies, software as a service (SaaS) and financial...

  • Sr Sales Representative

    2 weeks ago

    Salt Lake, Utah, United States Utah Transit Authority Full time

    Job DescriptionUtah Transit AuthorityHere at UTA we move youUTA exists to serve people. Everything we do and everyone we serve is done through our people, so we are focused on developing our people. We have a can-do attitude and make delivering our service a key priority and is the reason why we are an organization focused on sharing best practices and...

  • Patient Support Service Representative Nights

    1 month ago

    Salt Lake, Utah, United States HCA Healthcare Inc Full time

    Description IntroductionAre you looking for a work environment where diversity and inclusion thrive? Submit your application for our Patient Support Service Representative opening with St. Mark's Hospital today and find out what it truly means to be a part of the HCA Healthcare team.BenefitsSt. Mark's Hospital, offers a total rewards package that supports...

  • Patient Support Service Representative Nights

    1 month ago

    Salt Lake, Utah, United States HCA Healthcare Full time

    Description IntroductionAre you looking for a work environment where diversity and inclusion thrive? Submit your application for our Patient Support Service Representative opening with St. Marks Hospital today and find out what it truly means to be a part of the HCA Healthcare team.BenefitsSt. Marks Hospital, offers a total rewards package that supports the...

  • Patient Support Service Representative Nights

    4 weeks ago

    Salt Lake, Utah, United States HCA Healthcare Inc Full time

    Description IntroductionAre you looking for a work environment where diversity and inclusion thrive? Submit your application for our Patient Support Service Representative opening with St. Mark's Hospital today and find out what it truly means to be a part of the HCA Healthcare team.BenefitsSt. Mark's Hospital, offers a total rewards package that supports...

  • Global Connected Systems Specialist I

    4 weeks ago

    Salt Lake, Utah, United States bioMerieux SA Career Site - MULTI-LINGUAL Full time

    Description Position Summary:The Global Connected System Specialist I (GCSS I) provides L2 applications and technical support including networking connectivity and utilization, along with general software and applications support for bioMérieux products. The CSS is also responsible for training, troubleshooting, and project management to internal and...

  • Global Connected Systems Specialist I

    1 month ago

    Salt Lake, Utah, United States bioMerieux SA Career Site - MULTI-LINGUAL Full time

    Description Position Summary:The Global Connected System Specialist I (GCSS I) provides L2 applications and technical support including networking connectivity and utilization, along with general software and applications support for bioMérieux products. The CSS is also responsible for training, troubleshooting, and project management to internal and...

  • Environmental Health Specialist I/II/SENIOR

    2 weeks ago

    Salt Lake, Utah, United States County of Lake, California Full time

    General Recruitment InformationHealth ServicesEnvironmental Health DivisionLake County, CaliforniaApply now and be part of our dynamic Environmental Health team The Environmental Health division promotes and protects the health of our community through education and enforcement of public health laws. As part of the Environmental Health, you'll contribute to...

  • Quality Engineer I

    4 weeks ago

    Salt Lake, Utah, United States bioMerieux SA Career Site - MULTI-LINGUAL Full time

    Description This is a full-time exempt position. The Quality Engineer I is responsible for assisting with the maintenance of technical aspects of the Quality Management System, including investigations, validations, corrective actions, risk management, and continuous improvement efforts. This person will be working with BioFire employees outside of Quality...

  • Quality Engineer I

    2 months ago

    Salt Lake, Utah, United States bioMerieux SA Career Site - MULTI-LINGUAL Full time

    Description This is a full-time exempt position. The Quality Engineer I is responsible for assisting with the maintenance of technical aspects of the Quality Management System, including investigations, validations, corrective actions, risk management, and continuous improvement efforts. This person will be working with BioFire employees outside of Quality...

  • Customer Service Representative- Salt La

    4 weeks ago

    Salt Lake, Utah, United States AppleOne - United States Full time

    Fortune 500 Company is seeking Customer Service Representative to join the team. This position offers an opportunity for growth and advancement within the company, intending to transition the successful candidate into a full-time employee. You will be initially shipping RSA devices to customers but once shipping responsibilities are mastered, you would move...

  • Customer Service Representative- Salt La

    1 month ago

    Salt Lake, Utah, United States AppleOne - United States Full time

    Fortune 500 Company is seeking Customer Service Representative to join the team. This position offers an opportunity for growth and advancement within the company, intending to transition the successful candidate into a full-time employee. You will be initially shipping RSA devices to customers but once shipping responsibilities are mastered, you would move...

  • Courier I

    1 month ago

    Salt Lake, Utah, United States ARUP Laboratories Full time

    Schedule:Tuesday - Saturday (40 hrs/wk)10:30 AM - 7:00 PM30 min. lunchTraining Schedule:(Same as above)Department: Transportation, Local - 230Primary Purpose:Works under close supervision to learn the policies and processes in Transportation. Learns to receive, transport, and deliver all lab specimens, reports, supplies, and personnel in a timely and...