Located on a tree-lined campus on the Iowa River in Iowa City, Iowa, the University of Iowa is the state’s oldest institution of higher education and one of t
Revenue Cycle Representative (Prior Authorization) - Patient Access Management (PAM) - Patient Financial Services (PFS)
Location
United States
Posted
71 days ago
Salary
0
Seniority
Mid Level
No structured requirement data.
Job Description
Revenue Cycle Representative (Prior Authorization) - Patient Access Management (PAM) - Patient Financial Services (PFS)
University of Iowa
Position Summary: University of Iowa Health Care department of Patient Financial Services is seeking a Prior Authorization Revenue Cycle Representative (RCR) to join our team. The Prior Authorization Revenue Cycle Representative is a financial clinical support healthcare position focused on delivering exceptional customer service. The Prior Authorization Revenue Cycle Representative is instrumental in ensuring a seamless experience for both external stakeholders—patients, their families, and insurance representatives—and internal partners, including nurses, technicians, physicians, and other staff at Iowa Health Care. The Prior Authorization Revenue Cycle Representative will work in a high volume, fast-paced, web-based application environment and support a culture of Service Excellence by delivering high quality customer service and maintaining composure in demanding situations. This position will primarily focus on performing prior authorization functions and insurance benefit coverage investigations. The Prior Authorization Revenue Cycle Representative must have a demonstrated ability to prioritize, multi-task, and quickly change focus in a dynamic team environment. The ability to exhibit compassion and empathy when collaborating directly with patients and/or their families is critical. A person in this role will provide consistent and comprehensive information (both in writing and verbally) to providers, clinical teams, patients, external entities and various administrative and management personnel regarding third party, patient billing and customer service activities. This position is eligible to participate in remote work within the state of Iowa and applicants who wish to work remotely will be considered. Training will be held either ONSITE or via ZOOM from the HSSB building at a length determined by the supervisor. Remote eligibility will be evaluated upon a satisfactory job training opportunity. Per policy, work arrangements will be reviewed annually and must comply with the remote work program and related policies and employee travel policy when working at a remote location. University of Iowa Health Care—recognized as one of the best hospitals in the United States—is Iowa's only comprehensive academic medical center and a regional referral center. Each day more than 12,000 employees, students, and volunteers work together to provide safe, quality health care and excellent service for our patients. Simply stated, our mission is: Changing Medicine. Changing Lives.® WE CARE Core Values: - Welcoming - We have an environment where everyone has a voice that is heard; that promotes the dignity of our patients, trainees, and employees; and allows all to thrive in their health, work, research, and education. - Excellence - We achieve and deliver our personal and collective best in the pursuit of quality and accessible health care, education, and research. - Collaboration - We collaborate with health care systems, providers, and communities across Iowa and the region as well as within our UI community. We believe teamwork—guided by compassion—is the best way to work. - Accountability - We behave ethically, act with fairness and integrity, take responsibility for our own actions, and respond when errors in behavior or judgment occur. - Respect - We create an environment where every individual feels safe, valued, and respected, supporting the well-being and success of all members of our community. - Empowerment - We commit to fair access to research, health care, and education for our community and opportunities for personal and professional growth for our staff and learners. Position Responsibilities: - Ensure accurate validation of insurance eligibility, coverage details, network agreements, and financial obligations. - Obtain, track and complete prior authorizations, validate imaging, testing, procedure meets insurance company medical necessity criteria across various specialties. - This encompasses outpatient services and surgical/non-surgical procedures, whether elective, urgent, and same day. - Interact with physicians, nurses and clinical support staff on a case-by-case basis to obtain appropriate clinical documentation to ensure accurate indications in the patient’s medical record before completion of third-party prior authorizations. This may include contacting referring physicians for information. - Understand, anticipate, and respond to complex questions from clinical staff and insurance company nurse reviewer. When necessary, proactively contact third parties and initiate communication to ensure appropriate future payment. - Problem solves with insurance utilization review nurses, medical directors, providers, and other Iowa Healthcare staff to meet patient care needs. Identify and produce creative solutions to problems identified via the prior authorization process. - Appeal prior authorization denials and/or set-up peer to peer reviews. - Communicate with clinical teams on non-covered procedures/therapy/testing or exam coverage issues. Facilitate financial counseling for patients and families as directed by clinical team. - Assist with medical necessity documentation to expedite approvals, appeals and complete appropriate follow-up. - Utilize Epic to enter and track prior authorization information, retrospective reviews and denial follow-up efficiently/effectively. - Collaborate with other departments to assist in obtaining pre-authorizations in a cross-functional manner. - Maintain current knowledge of medical modalities as well as new protocols established for patient populations. - Maintain an extensive working knowledge and expertise of insurance companies and billing authorization/referral requirements, clinical guideline policies, payer regulations, financial classifications and financial assistance programs. - Develop and maintain an effective, supportive working relationship with nurses, imaging techs, clinic/OR surgery schedulers, coders, fiscal teams, referral sources and external entities. - Communicate with providers, payers, patients, internal departments, co-workers and prior authorization leadership to resolve authorization denial issues. - Identify & report undesirable trends and reimbursement modeling errors or underlying causes of incorrect payment; review allowed variances from third party payers. - Maintain a high-level of accuracy to meet productivity and quality requirements. - Review and analyze report data to provide status updates to leadership. - May perform other duties as assigned. Classification Title: Revenue Cycle Representative (Prior Authorization) Specified Area: Prior Authorizations Department: Patient Financial Services Percent of Time: 100%25 Pay Grade: 2B Location: Hospital Support Services Building (HSSB) located in Coralville, IA This position is eligible to participate in remote work and applicants who wish to work remotely will be considered. Training will be held either ONSITE or via ZOOM from the HSSB building at a length determined by the supervisor. Remote eligibility will be evaluated upon a satisfactory job training opportunity. Per policy, work arrangements will be reviewed annually and must comply with the remote work program and related policies and employee travel policy when working at a remote location. Equipment: - Onsite – The department will provide a workstation which contains 3 (three) monitors, laptop/power cord, docking station/power cord, keyboard, mouse, headset, and desk supplies can be found in the supply closet. - Hybrid – while working onsite, the department will provide a workstation which contains 3 (three) monitors, a laptop/power cord, docking station/power cord, keyboard, mouse, headset, and desk supplies. When working offsite, the employee will take their laptop/power cord to carry back and forth, a second docking station/power cord to keep offsite. Prior to working offsite, the employee, at their own expense, will need to supply 2 (two) monitors, a keyboard, a mouse, and provide a screen shot of the domicile internet speed (minimum 30mb download and 10mb upload) and a picture of the office setup. - Remote - when working offsite, the department will provide the employee a laptop/power cord, docking station/power cord, headset. Prior to working offsite, the employee, at their own expense, will need to supply 2 (two) monitors, a keyboard, a mouse, and provide a screen shot of the domicile internet speed (minimum 30mb download and 10mb upload) and a picture of the office setup. Education Required: - Bachelor’s degree or equivalent combination of education and relevant experience. Experience Requirements: - 6 months or more of related customer service experience in a professional, financial or health care related environment. - Knowledge of healthcare billing (healthcare revenue cycle); insurance, and/or federal and state assistance programs. - Strong attention to detail and with accuracy to achieve or exceed organizational and individual performance goals - Must be proficient in computer software applications, i.e., Microsoft Office Suite (Excel, Word, Outlook, PowerPoint) or comparable programs and an ability to quickly learn and apply new systems knowledge. - Demonstrated ability to handle complex and ambiguous situations with minimal supervision. - Self-motivated with initiative to seek out additional responsibilities, tasks and projects. - Effective communication skills (written and verbal), active listening skills and the ability to maintain professionalism while handling demanding situations with callers or customers. - Successful history collaborating in a fast-paced team environment. Desirable Qualifications: - Experience working in a complex hospital system is highly desirable. - Experience handling difficult callers, customers and patients. - Experience and knowledge of Patient Financial Services’ functions, systems, processes & policies. - Demonstrated ability to maintain or improve established productivity and quality requirements. - Knowledge of medical terminology. - Knowledge of anatomy and physiology. - Knowledge of Health Insurance Portability and Accountability Act (HIPAA) laws. - Experience identifying opportunities for improvement and making recommendations and suggestions. - Experience with multiple technology platforms such as Epic, Cirius ACD, and/or GE. - Ability to drive results and foster accountability throughout the team and organization. - Maintain current awareness of industry trends and continually strive for improvement with both technical and professional skills. Application Process: To be considered for an interview, applicants must upload the following documents and mark them as a “Relevant File” for the submission: - Resume - (optional) Cover Letter Job openings are posted for a minimum of 7 calendar days and may be removed from posting and filled any time after the original posting period has ended. Applications will be accepted until 11:59 PM on the date of closing. Successful candidates will be required to self-disclose any conviction history and will be subject to a criminal background check and credential/education verification. Up to 5 professional references will be requested at a later step in the recruitment process. Successful candidates will require a work arrangement form to be completed upon the start of your employment. Per policy, work arrangements will be reviewed annually, and must comply with the remote work program and related policies and employee travel policy when working at a remote location. For additional questions, please contact Zach Schmidt at zachary-e-schmidt@uiowa.edu. Applicant Resource Center: Need help submitting an application or accepting an offer? Support is available! Our Applicant Resource Center is now open in the Fountain Lobby at the Main Hospital. Hours: - Monday 10:00 am – 4:00 p.m. - Tuesday 10:00 am – 4:00 p.m. - Wednesday 10:00 am – 4:00 p.m. - Thursday 10:00 am – 4:00 p.m. - Friday 10:00 pm – 4:00 p.m. - Or by appointment - Contact TAHealthCareSupport@healthcare.uiowa.edu to schedule an appointment or just stop by. Visit the website for more information: Application Resource Center | University of Iowa Health Care
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Borrower Account Services Representative II
Texas Guaranteed Student Loan CorpTrellis Company is a nonprofit 501(c)3 corporation focused on helping people leverage the power of post-secondary education and learning to improve their quality of life and the communities where they live. For more than 40 years Trellis has served as a student loan guarantor, helping to provide trusted guidance and services that help student borrowers successfully repay their federal loans. We have invested in improving student success programs through numerous grants to colleges, universities, and research groups. Today we have expanded our services beyond higher education to include working with employers and community organizations. This combination of stability and vision creates a unique intersection: a startup environment at a company that also has a stable foundation.
Role Description Assist borrowers by negotiating and monitoring repayment arrangements serving the best interest of the Department of Education while considering individual borrower circumstances. Providing a high level of customer assistance by supplying detailed information pertaining to repayment and the various available programs in accordance with company policies and procedures, Fair Debt Collection Practices Act (FDCPA) laws, state privacy laws, treasury laws, Fair Credit Reporting Act (FCRA), Gramm-Leach-Bliley Act (GLBA), Telephone Consumer Protection Act (TCPA), Federal Family Education Loan Program (FFELP) regulations, and any other related regulatory compliance requirements. Essential Duties and Responsibilities - Provides borrowers and authorized 3rd party representatives with detailed information about available repayment programs and forgiveness/discharge options. - Analyzes borrower eligibility for federal programs following internal and regulatory policies. - Counsels borrowers to determine the appropriate program based on account eligibility, borrower’s current financial situation, and their ability to repay. - Counsels borrowers regarding the importance of repayment and the consequences of non-payment. - Researches and responds to borrower and employer correspondence, via email, letters, and documentation. - Adheres to and maintains current knowledge and compliance with FDCPA, (both State and Federal), Privacy Act, FCRA, GLBA, TCPA, and Health Insurance Portability and Accountability Act (HIPAA), as well as policies and procedures prescribed by governing agencies such as the Federal Communications Commission (FCC), Federal Trade Commission (FTC), and Consumer Financial Protection Bureau (CFPB). - Monitors accounts to ensure repayment is initiated as agreed to by the borrower. - Ensures compliance with all Trellis policies and procedures, scripts, and quality guidelines. - Accurately enters all information into the account management system. - Performs skip trace activity to gain location information. - Prepares accounts for involuntary repayment, including Administrative Wage Garnishment, Federal Offset, and State Offsets as applicable. Includes direct communication with employers regarding existing garnishments. - Effectively analyzes and manages assigned borrower work lists. - Processes Consolidation Applications, Rehabilitation Agreements, Financial Disclosure Forms, and other requests. - Initiates administrative forms and other information necessary for the borrower to satisfy selected program requirements. - Actively protects and secures Nonpublic Personal Information (NPI), safeguard Personally Identifiable Information (PII), and Protected Health Information (PHI). - Ensures borrowers are treated with the utmost respect and be mindful of customer interactions and the impact on both the Company and borrower. - Assists other teams within Borrower Services with high priority and or unexpected high-volume tasks including but not limited to: - Processes refunds and miscellaneous transactions to comply with changes in borrower status, Federal Guidance and Trellis Procedures. - Processes incoming and outgoing correspondence. - Assists with transactional and demographic updates as required. - Participates in training and other learning opportunities to ensure compliance and expand knowledge of company, position, and process. Non-Essential Duties and Responsibilities - May assist Spanish speaking borrowers. - Assist with claims processing as needed. - Provide feedback to Management on a variety of work-related processes and procedures to improve or enhance a process and performance. - Assist with training support of new and transferred team members. - Actively support the team and team responsibilities. - All other duties and responsibilities as assigned. Knowledge, Skills, and Abilities - Strong communication, numerical, analytical, critical thinking, and decision-making skills. - Must be proficient in written and verbal communications. - Strong understanding and ability to interpret and apply changing voluntary and involuntary repayment options available to the borrower, including understanding workflow and requirements of each program to be able to ascertain the account status. - Demonstrated ability to utilize software, scripts, run queries, and tools appropriately. - Demonstrated ability to prioritize work assignments and maintain activities within prescribed performance standards. - Accurately handle multiple tasks and be detail oriented in a fast-paced working environment. - Capable of learning new skills and adapting to change, work under pressure and meet established deadlines. - Ability to work with and protect sensitive or confidential information and documentation. - Strong negotiation and/or collection skills. - Strong, current knowledge of federal and state laws and regulations. - Intermediate Microsoft Office product proficiency. Qualifications - Education Required: High school diploma or equivalent. - Education Preferred: Some college, up to or including an associate degree. - Experience: Two (2) years office experience in loan servicing, collections, customer service, customer contact center, financial services, or student loan environment. Compensation and Benefits - Base Salary: $17.00 – $21.00 per hour (commensurate with experience). - Corporate Annual Incentive: This position is eligible for a corporate annual incentive, subject to the discretion and approval of the Board of Directors and not guaranteed. - Paid Holidays: 11 holidays + 1 floating holiday per year. - Comprehensive benefits package including health, dental, vision, and retirement plans. Physical and Mental Demands - Occasionally must move about inside the office. - Repetitive motion. Regularly operates a computer, phone, and general office equipment. - Regularly required to handle, feel, grasp objects, and reach across a work area. - Regularly communicates with other employees and on the phone, virtually, or in person with clients. Regularly converses with internal and external contacts. - Visual acuity. Regularly must have close visual acuity to view and enter information into computer and software systems, analyze data, develop presentations and reports, and other materials. - Mental focus. Requires worker to maintain focus and exchange detailed and accurate information through oral and written communication. Work Environment - Work may be conducted remotely or in an office with a surrounding small cubicle environment. - Office work environment is climate controlled with no substantial exposure to adverse environmental conditions. 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RELEASE COORDINATOR
Arizona Department of AdministrationThe Attorney General's Office offers a comprehensive benefits package. For a complete list of benefits provided by The State of Arizona, please visit our benefits page.
DEPARTMENT OF REVENUE Funding Arizona’s future through excellence in innovation, exceptional customer service and public servant-led continuous improvement. RELEASE COORDINATOR Job Location: Division of Information Technology 1600 W Monroe St Phoenix, AZ 85007 Posting Details: Salary: $92,399.84 Grade: 26 Closing Date: 4/27/26 Job Summary: The Release Management Specialist is responsible for guiding the complete software delivery life cycle. working with the team from the planning phase to the deployment phase through the development and testing phases. 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Stakeholder Communication and Coordination: - Bridges communications between developers, QA, DevOps and stakeholders ensuring alignment on release goals to include: - Communicating the project-related tasks, such as plans, timelines, requirements, etc., between different teams - Ensuring the allocation of release engineers to every release - Planning and providing weekly updates on the release activities - Communicating with release managers from different IT departments - Teaming up with relevant development teams responsible for building the automation tools used to develop and deploy the software - Scheduling / attending the CAB meetings to discuss the release schedules with the team and find roadblocks, if any. 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Certified Pharmacy Technician - Precertification, First Shift, Medication Access Services
UC HealthUC Health is a hospital and healthcare organization that consists of the University of Cincinnati Medical Center, its flagship facility, and the state-of-the-art West Chester Hospi
Location: UC Health Business Center, remote Department: Medication Access Services, Pharmacy Hours: 0800-1630 Monday-Friday Shift: First Shift UC Health is hiring a full-time Certified Pharmacy Technician in the Medication Access Services Pharmacy at University of Cincinnati’s Medical Center. We are also offering a $2000 sign-on Bonus! This position is with the Precertification team in Medication Access Services. This role works to precertify and get approval on medical benefits for infusions, chemotherapy and other medications given by healthcare providers in UC Health clinics. This involves verification of insurance benefits, identification of medications that require precertification, submission to insurance for prior authorization for those drugs, and communication with clinical and operations teams to facilitate patient care. Pharmacy technicians assist pharmacists in preparing and distributing medications, maintaining the drug inventory, and maintaining patient records. Pharmacy technicians work only under the supervision of a registered pharmacist. They do not perform duties that can legally be performed by only a registered pharmacist. In addition to responsibilities for a Tech I, Pharmacy Technician II demonstrates a high level of initiative and motivation along with competency in a specialized area(s) of the department. About University of Cincinnati Medical Center As part of the Clifton Campus of UC Health, Greater Cincinnati’s academic health system, University of Cincinnati Medical Center has served Greater Cincinnati and Northern Kentucky for nearly 200 years. Each year, hundreds of thousands of patients receive care from our world-renowned clinicians and care team. Our experts utilize the most advanced medical knowledge and technology available, providing a level of specialty and subspecialty medical care that is not available anywhere else in Greater Cincinnati. Unit Details: - Opportunities for professional development- Technician Advancement Program - Medical, Dental, and Vision Insurance - Employee Paid Short- and Long-Term Disability - 401K - Tuition Reimbursement Opportunities - Community Discounts At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering. As the region's adult academic health system, we strive for innovation and provide work-class care for not only our community, but patients from all over the world. Join our team and you'll be able to develop your skills, grow your career , build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors. UC Health is committed to providing an inclusive, equitable and diverse place of employment.
• Own daily operations of the assigned Client Support team, including ticket flow, queue management, prioritization, scheduling, and shift coverage • Ensure services are delivered consistently in accordance with established processes, SLAs, and standards • Monitor and manage escalation workflows with proper documentation and routing • Oversee dispatch effectiveness in partnership with Client Support Coordinators • Own service performance metrics, including SLA attainment, ticket aging and backlog health, first-contact resolution, reopened ticket rates, and client satisfaction (CSAT) • Provide reporting and operational insights, identifying trends, risks, and corrective actions • Manage Client Support Coordinators, Supervisors (where applicable), and Analysts • Conduct regular team meetings and 1:1s • Set clear expectations for performance, professionalism, and adherence to process • Lead hiring, onboarding, performance reviews, compensation recommendations, and disciplinary actions • Drive career development planning and visibility into growth paths • Identify skill gaps and coordinate training and certification opportunities • Foster a culture of accountability, collaboration, and client-centered service • Own the client experience across the assigned team • Serve as the operational escalation point for service delivery issues • De-escalate client situations, communicate accountability, and restore confidence • Participate in client meetings for operational reviews and escalations • Use data to guide staffing decisions and workflow improvements • Identify opportunities to reduce inefficiencies and improve client experience • Enforce and maintain service delivery processes and standards within the PSA • Monitor team utilization and workload balance • Partner with leadership on contract-level profitability and corrective actions • Coordinate with Support Escalation teams for effective ticket handoffs • Partner with Project Delivery on client onboarding transitions • Collaborate with Infrastructure & Security Operations on cross-functional issues • Work with other Client Support Managers to align standards and share best practices
