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Overview

_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 insurance receivables collections, denials resolution and internal/external customer service. Account portfolio may include accounts less complex in nature. This position is not responsible for providing patient care.

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

+ Performs insurance follow-up and denial resolution on outstanding claims.

+ Performs contract compliance on outstanding claims, ensuring timely and appropriate reimbursement based on contract terms.

+ Performs payment compliance reviews and resolutions based on projects focused by payer, service, entity, trend, etc., as assigned by unit leader.

+ Ensures appropriateness of patient responsibility, as assigned by payer/contract/benefit.

+ Resolves clinical and/or authorization denials through CARC analysis and appeals - including clinical documentation review and coordination with UR and/or attending physician.

+ Acts as patient advocate in the resolution of balances.

+ Prepares and monitors high dollar spreadsheets and/or payer escalations spreadsheets, as assigned.

+ Escalates claim issues internally to other key departments including Coding, Billing, Charging, Contracting, etc.

Knowledge / Skills / Abilities

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

+ Ability to organize and prioritize work to meet productivity expectations and/or deadlines.

+ Ability to identify root cause of issue and design logical approach for resolution.

+ Ensures accuracy and thoroughness in accomplishing tasks.

+ Takes ownership for the quality and timeliness of work and can achieve result with little oversight.

+ Promotes cooperation and commitment to team goals.

+ Ability to solicit and act on constructive feedback, challenge oneself and demonstrate resilience in the face of opposition.

+ Provides outstanding service through empathy, issue resolution and follow through.

Qualifications

Qualifications** **Required

+ Three years of medical billing experience, or equivalency.

Qualifications (Preferred)

Preferred

+ Understanding of Medical billing terminology or equivalent.

+ Demonstrated claims knowledge through AAHAM certification, or equivalency.

+ One year of coding experience using ICD-10.

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

Color Determination, Listening, Manual Dexterity, Near Vision, Pulling and/or Pushing, Sitting, Speaking, Standing

Multi-lingual Candidates Welcomed

_To inquire about this posting, email: [email protected]_

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 801-581-6500. 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 (OEO/AA). More information, including the Director/Title IX Coordinator's office address, electronic mail address, and telephone number can be located at:www.utah.edu/nondiscrimination/_

_Online reports may be submitted atoeo.utah.edu/_

_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 (801) 581-6500 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 Hospitals and Clinics Human Resources at (801) 581-6500 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** _75995_

**Reg/Temp** _Regular_

**Employment Type** _Full-Time_

**Shift** _Day_

**Work Schedule** _8am-5pm, Monday through Friday_

**Clinical/Non-Clinical Status** _Non-Clinical_

**Location Name** _Business Services Building_

**Workplace Set Up** _Hybrid_

**_City_** _SALT LAKE CITY_

**_State_** _UT_

**Department** _COR ISC 10D Denials Management_

**Category** _Finance/Accounting_

**Workplace Set Up** _Hybrid_