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

This position for use in Health Plans Departments only. This position is responsible for updating and maintaining eligibility information and coordinating insurance claims.

Corporate Overview: University of Utah Health is an integrated academic healthcare system with five hospitals including a level 1 trauma center, eleven community health centers, over 1,600 providers, and a health plan serving over 200,000 members. University of Utah Health is nationally ranked and recognized for our academic research, quality standards and overall patient experience. In addition to our clinical delivery system, we have a School of Medicine, School of Dentistry, College of Nursing, College of Pharmacy, and College of Health providing education and training for over 1,250 providers annually. We have over 2 million patient visits annually and research grants exceeding $350 million. University of Utah Hospitals and Clinics represents our clinical operations for the larger health system.

Responsibilities

Essential Functions

• Processes and maintains manual and electronic enrollment information.
• Researches eligibility and claims and updates system with correct information.
• Maintains and updates enrollment, files, and processes coordination of benefits claims.
• Processes medical claims involving enrollment and coordination of benefits laws and regulations.
• Coordinates member insurance information with other state, federal and commercial insurance carriers and providers.
• Adheres to department quality and production processing standards.
• Acts as a liaison between the organization and insurance providers.

Knowledge / Skills / Abilities

• Knowledge of Medicaid, commercial insurance, and Medicare.

• Demonstrated proficiency in the use of Microsoft Office software.

• Strong written and verbal communication skills.

Qualifications

Required

• Associate's degree, or equivalency which could include two years of experience in insurance, medical claims processing, and benefits enrollment processing.

Qualifications (Preferred)

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

Carrying, Climbing, Color Determination, Crawling, Far Vision, Lifting, Listening, Manual Dexterity, Near Vision, Pulling and/or Pushing, Reaching, Sitting, Speaking, Standing, Stooping and Crouching, Walking