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 for informing and assisting patients with their financial obligations for health care services through education, coverage enrollment assistance, financial hardship applications, or other programs. This position is not responsible for providing care to patients.

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.

• Conducts interviews and screenings for unfunded patients to determine all available funding sources (s) including commercial insurance, government programs (Medicare, Medicaid), Crime Victims, Affordable Care Act plans, Third Party Liability, or other programs/sources.
• Works with government agencies, third party payers, and other key parties to process applications, paperwork or other requirements until completion and/or resolution.
• Assists uninsured patients with financial hardship applications. May grant full or partial charity, prompt pay discounts, or payment arrangements, as necessary.
• Creates service price estimates based on insurance benefits and/or self-pay status for upcoming services on prospective patients.
• Collects estimated patient responsibility throughout the revenue cycle both in person and over the phone.
• May coordinate and obtain "Certificate of Medical Necessity" or other approval for scheduled services when patient is unable to make a substantial or minimum payment towards services.
• Coordinates communication with patients, families, providers, or other key parties when authorization or benefits are not secured.
• May obtain prior authorizations from insurance carrier, including CPT code determination and submission of required documentation.
• Displays and understands the difference between individual and collective accountability; promotes cooperation and commitment to team goals.
• May perform other duties as assigned.

Knowledge / Skills / Abilities

• The ability to express information in a clear and understandable manner.

• Demonstrated exceptional time management skills.

• The ability to service and resolve customer requests with the customer in mind, first and foremost.

• Ability to take ownership for the quality and timeliness of work and can achieve results with little oversight.

• Ability to solicit and act on constructive feedback, challenge oneself with tough assignments, and demonstrate resilience and courage in the face of setbacks and oppositions.

Qualifications

Required

• Three years of experience with medical accounts receivable, insurance claims, or equivalency.
• High School Diploma, or equivalency.

Preferred

• Bilingual language skills may be preferred.
• Experience with the Medicaid enrollment process.
• Coding certifications such as CCS, CPC-H, or CPC-P.
• Knowledge of CPT , ICD9/10 and DRG codes.

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.