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Prior Authorization Representative II
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|Job Title||Prior Authorization Representative II|
|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||$18.32 - $19.24|
|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.
Work Environment and Level of Frequency typically required
Three years experience in a health care financial setting or equivalency. Six months or more as a Prior Authorization Rep I or equivalent prior authorization experience. Knowledge of CPT, ICD9/10 and DRG codes.
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. CPC Certification
|Special Instructions Summary|
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.
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