Claims Specialist I

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, integrity, quality and trust that are integral to our mission. EO/AA

This position is responsible for government insurance receivables collections, denials resolution and internal/external customer service. Responsible for claim submission and rejections. Account portfolio will include accounts exceeding $10,000 per claim. 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

Essential Functions

• Performs denial resolution on outstanding claims.

• Performs billing compliance on new and outstanding claims ensuring timely and appropriate reimbursement based on regulatory guidance.

• Escalates claims and issues for resolution.

• Performs appropriate actions based on HIPAA transactions and billing regulations.

• Evaluates and resolves claim rejections.

• Takes ownership for the quality and timeliness of work and achieves result with little oversight.

• Approaches every customer encounter with the attitude that the customer is right with the intent of first touch resolution.

Knowledge / Skills / Abilities

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

• Demonstrated attention to detail, and a logical approach to resolutions, and the ability to resolve difficult or complicated challenges.

• Demonstrated effective time management skills.

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

Qualifications

Required

• Three years of medical billing experience.

• High School Diploma, or equivalency.

Qualifications (Preferred)

Preferred

• Understanding of Medical Billing terminology.

• AAHAM certification, or equivalency.

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

Listening, Sitting, Speaking, Standing

Multi-lingual Candidates Welcomed

To inquire about this posting, email: View email address on click.appcast.io

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 and patients from all backgrounds and possess a strong commitment to improving access to higher education and quality healthcare for historically underrepresented students and patient populations.

All qualified individuals 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 View phone number on click.appcast.io. 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 (OEO). More information, including the Director/Title IX Coordinator's office address, electronic mail address, and telephone number can be located at:

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 View phone number on click.appcast.io 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 View phone number on click.appcast.io or View phone number on click.appcast.io or Hospitals and Clinics Human Resources at View phone number on click.appcast.io 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 82792
Reg/Temp Regular
Employment Type Full-Time
Shift Day
Work Schedule 8:00 AM - 4:30 PM, Monday - Friday
Clinical/Non-Clinical Status Non-Clinical
Location Name Business Services Building
Workplace Set Up Remote
City SALT LAKE CITY
State UT
Department COR ISC 10D CLAIMS MANAGEMENT
Category Finance/Accounting
Workplace Set Up Remote