- Serve as principal contact and subject matter expert for HTC and/or department staff regarding prior authorization process for services rendered at both the HTC AMC and Outreach clinics.
- Obtain, review and input insurance authorization and referrals prior to patient services, and throughout treatment to maintain continuance of authorizations. Advocate for the patient, utilizing knowledge of coverage-based guidelines and treatments.
- In collaboration with CU Medicine, identify and provide accurate CPT/ICD codes where needed for reimbursement.
- Maintain appropriate logs and reports to professional, State and Federal requirements; including but not limited to Medicaid, Medicare, case logs, and drug logs as required.
- Follow up on denied authorization requests, escalate to appointed appeal personnel, and relay the necessary denial detail to the provider to support the appeal and/or peer-to-peer reviews.
- Serve as the primary resource to patients regarding the prior authorization process. Explain requirements, terminology, billing process, consent requirements, collect insurance info, etc., as necessary.
- Work closely with the Pharmacy Revenue Cycle Specialist to coordinate and maximize HTC reimbursements and provide backup coverage when absent from office.
- A bachelor's degree in business management or administration or a directly related field from an accredited institution.
- Substitution: A combination of education and related technical/paraprofessional experience may be substituted for the bachelor's degree on a year-for-year basis.
- At least five (5) years in this field or related field such as medical coding, financial counseling setting or similar service profession.
- Strong knowledge of ICD9/10 diagnosis codes, as well as CPT codes.
- Knowledge/experience obtaining authorizations for Physician Dispensed Drugs (PDA) on a buy and bill basis.
- Knowledge of EPIC EMR authorization and referral processes.
- Previous front office outpatient clinic experience.
- Previous billing, public and private pay experience.
- Bilingual (English/Spanish).
- Ability to communicate effectively, both in writing and orally in English and preferably Spanish.
- Ability to establish and maintain effective working relationships with employees at all levels throughout the institution.
- Outstanding customer service skills.
- Demonstrated commitment and leadership ability to advance diversity and inclusion.
- Ability to take direction and use independent judgment to coordinate various projects and meet multiple deadlines.
- A letter of interest describing relevant job experiences as they relate to listed job qualifications and interest in the position
- Curriculum vitae / Resume
- Three to five professional references including name, address, phone number (mobile number if appropriate), and email address
-
University of Colorado Denver, CO , USA, United StatesAs a key member of the Revenue Cycle Team, the Prior Authorization and Payer Reimbursement Specialist (PAPR) at the CU Hemophilia and Thrombosis Center (HTC) is tasked with obtaining claim authorizations from payers for outpatient services and physic Authorization, Coordinator, C ...
-
Plasma Center Technician
3 weeks ago
BioLife Plasma Services Aurora, United StatesBy clicking the "Apply" button, I understand that my employment application process with Takeda will commence and that the information I provide in my application will be processed in line with Takeda's Privacy Notice and Terms of Use. I further attest that all information I subm ...
-
Bilingual Spanish- Plasma Center Nurse- RN
2 weeks ago
BioLife Plasma Services Aurora, CO, United StatesBy clicking the "Apply" button, I understand that my employment application process with Takeda will commence and that the information I provide in my application will be processed in line with Takeda's Privacy Notice and Terms of Use . I further attest that all information I sub ...
-
bilingual spanish- plasma center nurse- lpn
3 weeks ago
BioLife Plasma Services Aurora, CO , USA, United StatesBy clicking the Apply button, I understand that my employment application process with Takeda will commence and that the information I provide in my application will be processed in line with Takeda's Privacy Notice and Terms of Use . I further attest that all information I submi ...
-
Medical Billing Reimbursement Specialist
2 weeks ago
Zoll Medical Corporation Broomfield, CO, United StatesMedical Billing Reimbursement Specialist · Locations: Broomfield, CO; Remote, TN, United States of America; Remote, FL, United States of America; Placeholder, GA, United States of America; Placeholder, CO, United States of America; Remote, MN, United States of America; Remote, AZ ...
-
mds coordinator
3 weeks ago
Nexion Health Aurora, CO , USA, United StatesYour talents, skills and hearts are in high demand. Join our team of collaborative healthcare professionals and work closely with a cross-functional team to create an environment of quality health and wellness of the minds, bodies and spirit s of our residents. APPLY TODAY · Abou ...
-
Home Health RN
3 days ago
Colorado Visiting Nurse Association Aurora, United States Full timeColorado Visiting Nurse Association has immediate openings for Home Health RN Case Managers. Be part of the best, longest standing, and largest network provider of home health, hospice, and palliative care in Colorado. Home Health provides an intimate setting to care and spend mo ...
-
Front Desk Coordinator
2 weeks ago
Community Reach Center Broomfield, United StatesWe're Excited You're Here · Looking to join a compassionate community dedicated to providing exceptional mental health outcomes? Community Reach Center is that place. We prioritize empowering individuals living with mental health conditions, engaging with partners to make a lasti ...
-
Clinical Instructor Respiratory Therapist
2 weeks ago
UCHealth Aurora, United States· Summary: · Functions as a competent clinical respiratory therapist responsible for the coordination, supervision, and evaluation of respiratory therapy student educational experiences. Includes a clinical faculty appointment at the partnering school, practicing within the Clin ...
-
Care Coordinator
2 weeks ago
US Health Services Aurora, United StatesDescription · Summary: · At the direction of professional Care Management or Social Work staff, coordinates transitions of care, conducts and documents socio-economic review and screening to support the coordination of care. · Work Schedule: Full Time Days · Responsibilities: ...
-
UCHealth Aurora, United States· Location: UCHealth Anschutz Outpatient Pavilion, US:CO:Aurora · Department: Transplant Center · FTE: Full Time, 1.0, 80.00 hours per pay period (2 weeks) · Shift: Days · Pay: $ $63.33 / hour. Pay is dependent on applicant's relevant experience · Summary:Provides nursing care ...
-
Board Certified Behavior Analyst
2 weeks ago
Succeed ABA Aurora, United States FreelanceSucceed ABA - · Job Type: Part-time · Independent Contractor / 1099 · $ $85.00 per hour · Looking to make a difference in a child's life? Join Succeed ABA. · Join the company you always dreamed of Succeed ABA is a leading provider of Applied Behavior Analysis (ABA) services for ...
-
Staff Accountant- Tax
2 weeks ago
Flatiron Construction Corp. Broomfield, United StatesOverview · As a Tax Staff Accountant at Flatiron, you will be responsible for assisting in tax compliance preparation of federal, state and local, and international income taxes, transaction taxes, ad valorum taxes and other tax matters of the company. · What you will be doing · ...
-
Asset Management Technician
3 weeks ago
ECCV Water District Aurora, United StatesEast Cherry Creek Valley Water and Sanitation District (ECCV) has been sustaining our community by providing safe and reliable water since 1962. Sourced from the South Platte River and non-tributary aquifers, ECCV distributes water to approximately 65,000 customers in the eastern ...
-
Utilization Management RN
2 days ago
UC Health Aurora, United StatesUtilization Management RN · , "title" : "Utilization Management RN", "description" : " · Description · Location: UCHealth UCHlth 2450 Peoria Admin Services, US:CO:Aurora · Department: UCHlth Patient Line Referrals · FTE: Full Time, 0.8, 64.00 hours per pay period (2 weeks) · Shi ...
-
Warming associate
2 weeks ago
Golden State Foods Aurora, United StatesOverview · Quality Custom Distribution now hiring Warehouse Warming Associates ($19/hr) · For immediate consideration Please contact Elliott (Recruiter · Job Description · + 7am Start (Work 4 days on, 3 days off) · + Must have weekend flexibility (Sat or Sun) · + These are physi ...
-
Warming associate
2 weeks ago
Quality Custom Distribution Aurora, United StatesOverview · Quality Custom Distribution now hiring Warehouse Warming Associates ($19/hr) · For immediate consideration Please contact Elliott (Recruiter · Job Description · * 7am Start (Work 4 days on, 3 days off) · * Must have weekend flexibility (Sat or Sun) · * These are physi ...
-
Sales Coordinator Branch
3 weeks ago
Crown Equipment Aurora, United StatesSales Coordinator Branch · Location: · Aurora, CO, US, 80011 · Company Description: · Crown Equipment Corporation, one of the world's largest lift truck manufacturers, offers local support on a global scale with more than 15 manufacturing facilities worldwide and more than 500 re ...
-
Speech Language Pathologist
1 week ago
Developmental Pathways Aurora, United StatesJob Details · Job Location · Developmental Pathways - Aurora Office - Aurora, CO · Position Type · FT - 40 hrs/week · Education Level · Bachelors · Salary Range · $72, $80,143.00 Salary/year · Job Shift · Day · Description · Are you a licensed SLP in Colorado looking f ...
-
Dental Lab Technician II
2 weeks ago
NDX Aurora, United StatesJoin National Dentex (NDX) - a leading healthcare organization specializing in the dental industry. We offer a full spectrum of specialized products, services, and technologies to address any dental restoration need. Currently, we have 50 labs throughout the country. Our team is ...
prior authorization and payer reimbursement coordinator - Aurora, CO , USA, United States - University of Colorado
Description
University of Colorado Anschutz Medical CampusDepartment:
Pediatrics - Hemophilia & Thrombosis Center
Job Title:
Prior Authorization and Payer Reimbursement Coordinator
Position #:
Requisition: #33254
Job Summary:
As a key member of the Revenue Cycle Team, the Prior Authorization and Payer Reimbursement Specialist (PAPR) at the CU Hemophilia and Thrombosis Center (HTC) is tasked with obtaining claim authorizations from payers for outpatient services and physician administered drugs while ensuring compliance with reimbursement requirements.
This involves collecting demographic, insurance, and clinical information from patients and conducting insurance verification processes, including verifying patient eligibility, and coordinating medical benefits.
The PAPR specifically consults with the HTC Clinical Team, the University of Colorado Medicine revenue cycle team, the HTC Specialty Pharmacy, and the HTC Finance Team to manage and maximize clinical revenues.
Key Responsibilities:
Why Join Us:
The Hemophilia & Thrombosis Center (HTC) is an internationally renowned specialized disease management center for children and adults within the University of Colorado, School of Medicine.
The HTC provides direct comprehensive diagnostic and treatment services to over 3000 adult and pediatric patients with rare chronic bleeding and clotting disorders throughout a multiple-state region.
The Center encompasses a freestanding School of Medicine clinic, aspecialty pharmacy, research laboratories, clinical research services, professional training, patient education, and patient outreach and support programs.
The University of Colorado offers a comprehensive benefits package that includes health insurance, life insurance, retirement plans, tuition benefits, ECO pass, paid time off - vacation, sick, paid holidays, and more.
To see what benefits are available, please visit:
Diversity and Equity:
The University of Colorado Anschutz Medical Campus is committed to recruiting and supporting a diverse student body, faculty, and administrative staff.
Qualifications:
Minimum
Qualifications:
Preferred
Qualifications:
Knowledge, Skills, and Abilities:
How to Apply:
For full consideration, please submit the following document(s):
Questions should be directed to:
Steven Powell,
Screening of Applications Begins:
Applications will be accepted until finalists are identified, but preference will be given to complete applications received by April 30, 2024.
Anticipated Pay Range:
The hiring range for this position has been established as $76,517 to $97,330.
The above hiring range represents the University's good faith and reasonable estimate of the range of possible compensation at the time of posting.
Your total compensation goes beyond the number on your paycheck. The University of Colorado provides generous leave, health plans and retirement contributions that add to your bottom line.
Total Compensation Calculator:
ADA Statement:
The University will provide reasonable accommodations to applicants with disabilities throughout the employment application process. To request an accommodation pursuant to the Americans with Disabilities Act, please contact the Human Resources ADA Coordinator at
Background Check Statement:
The University of Colorado Anschutz Medical Campus is dedicated to ensuring a safe and secure environment for our faculty, staff, students, and visitors.
Vaccination Statement:
CU Anschutz strongly encourages vaccination against the COVID-19 virus and other vaccine preventable diseases.
If you work, visit, or volunteer in healthcare facilities or clinics operated by our affiliated hospital or clinical partners or by CU Anschutz, you will be required to comply with the vaccination and medical surveillance policies of the facilities or clinics where you work, visit, or volunteer, respectively.
In addition, if you work in certain research areas or perform certain safety sensitive job duties, you must enroll in the occupational health medical surveillance program.