Coordinator, Prior Authorization

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
• Free transit on most UTA services
• Employee discounts on a variety of products and services
• Professional development opportunities

Responsibilities:

1. Verifies insurance eligibility, benefits, and network status.
2. Ensures accurate ICD, CPT codes and related medical records are submitted in the authorization request.
3. Obtains pre-authorization and referrals from insurance companies for diagnostic testing, procedures, treatments, and medication as ordered by healthcare providers.
4. Follows up on delayed or denied authorization requests and escalates for resolution.
5. Creates detailed documentation and maintains/stores the authorization paper trail.
6. 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.
7. Effectively work with other team members in order to complete tasks efficiently and collaboratively.
8. 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.
• 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.

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.

Special Instructions Summary:

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.