"Coordinator, Prior Authorization"

The Division of Pediatric Clinical Enterprise at the University of Utah School of Medicine has an immediate opening for a Scheduling and Prior Authorization Coordinator. This position works with a team of professionals responsible for obtaining prior authorization before services are rendered for requested procedures, testing, and medications. Responsibilities also include the coordination and scheduling of certain procedures and tests. This position works with physicians, nurses, clinic managers and financial advocates to resolve issues that arise during the prior authorizations process.

A high level of computer literacy for daily navigation through multiple electronic systems, trouble shooting, and completion of tasks is necessary. This position is team-based where excellent communication and collaboration are vital components for completing responsibilities in an efficient and timely manner.

The University of Utah offers a comprehensive benefits package including: Excellent health care coverage at affordable rates, 14.2% retirement contributions that vest immediately, Generous paid leave time, 11 paid Holidays per year, 50% tuition reduction for employees, spouses, and dependent children, Flex spending accounts, University provided basic employee life insurance coverage equal to a salary of up to $25,000, Variety of elective insurance coverage, including life insurance, short and long-term disability, accidental death & dismemberment, accident, critical illness, hospital indemnity, and pet insurance, Free transit on most UTA services, Employee discounts on a variety of products and services, including cell phones & plans, entertainment, health and fitness, restaurants, retail, and travel, Professional development opportunities.

Responsibilities

• Verifies insurance eligibility, benefits, and network status.
• Ensures accurate ICD, CPT codes and related medical records are submitted in the authorization request.
• Obtains pre-authorization and referrals from insurance companies for diagnostic testing, procedures, treatments, and medication as ordered by healthcare providers.
• Follows up on delayed or denied authorization requests and escalates for resolution.
• Creates detailed documentation and maintains/stores the authorization paper trail.
• Depending on the area of assignment, coordinates schedules for surgery and surgical procedures, testing and other services as requested and in accordance with departmental policy and procedures.
• Effectively work with other team members in order to complete tasks efficiently and collaboratively.
• Participates in quality improvement projects by developing data collection tools, analyzing, compiling and reporting data, and providing input to the QI process.

Work Environment and Level of Frequency typically required: Nearly Continuously: Office environment.

Physical Requirements and Level of Frequency that may be required: Nearly Continuously: Sitting, hearing, listening, talking. Often: Repetitive hand motion (such as typing), walking. Seldom: Bending, reaching overhead.

Comments: The staff member must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served on his or her assigned unit. The individual must demonstrate knowledge of the principles of life span growth and development and the ability to assess data regarding the patient's status and provide care as described in the department's policies and procedures manual.

Disclaimer: This job description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to the job.

Minimum Qualifications: Three years of experience working in an office or clinic, with an emphasis in scheduling, or a related area, or equivalency (one year of education can be substituted for two years of related work experience); and demonstrated effective communication, human relations, and computer skills required. Some areas of assignment require completion of a medical terminology course, certification related to specific area, and/or additional years of related experience. This position is patient-sensitive and must fulfill all associated requirements. We protect our patients, coworkers, and community by requiring all patient-sensitive employees to be immunized according to CDC standards and hospital policy. Limited exemptions may be made for documented medical contraindications or religious beliefs that object to vaccinations. Applicants must demonstrate the potential ability to perform the essential functions of the job as outlined in the position description.

Preferences: Previous experience with medical insurance, prior-authorizations and ICD/CPT Coding experience preferred.