DME Pre-Authorization Specialist
University of Colorado Anschutz Medical Campus

DME Pre-Authorization Specialist - 27946 University Staff

Description
University of Colorado | CU Anschutz Medical Campus

School of Medicine | Department of Orthopedics

Official Title: Healthcare Professional

Working Title: DME Pre-Authorization Specialist

Position # 00790153 – Requisition #27946

* Applications are accepted electronically ONLY at www.cu.edu/cu-careers *

The University of Colorado has a requirement for COVID-19 vaccinations and full completion thereof by 9/1/21 or upon start date. Information regarding this requirement, and exemptions can be found at:

Anschutz: https://www.ucdenver.edu/docs/librariesprovider284/default-document-library/3000-general-admission/3012---covid-19-vaccination-requirement-and-compliance.pdf?sfvrsn=4e9df3ba_2

Denver: https://www.ucdenver.edu/coronavirus

Exemptions vary by campus location/department.

Campus/Unit-Specific Exemptions:

• Anschutz Campus – Exemptions are allowed for medical or religious reasons.
• Denver Campus - Exemptions are allowed for medical, religious, or personal reasons.
• Consolidated/Central Services Administration – Will follow Anschutz policy on exemptions.

The University of Colorado Anschutz Medical Campus seeks individuals with demonstrated commitment to creating an inclusive learning and working environment. We value the ability to engage effectively with students, faculty, and staff of diverse backgrounds.

The University of Colorado Anschutz Medical Campus is a world-class medical destination at the forefront of transformative science, medicine, education, and patient care. The campus encompasses the University of Colorado health professional schools, more than 60 centers and institutes, and two nationally ranked independent hospitals - UCHealth University of Colorado Hospital and Children's Hospital Colorado - that treat more than two million adult and pediatric patients each year. Innovative, interconnected and highly collaborative, the University of Colorado Anschutz Medical Campus delivers life-changing treatments, patient care and professional training and conducts world-renowned research fueled by over $650 million in research grants. For more information, visit www.cuanschutz.edu.

The Department of Orthopedics has an opening for a full-time University Staff (unclassified) Healthcare Professional.

Nature of Work

This position is responsible for providing accurate and complete data for Durable Medical Equipment (DME) precertification and preauthorization requests, and to provide excellent customer service.

Examples of Work Performed

• This position is responsible for prior authorizations related to the Orthopedics Orthotics program. This duty entails submitting the authorization via online portals or calling directly into the insurance provider to initiate the process. This position is responsible for the accurate submission of all medical records for suggested DME/orthotics, maintaining contact with insurance, and the submission of any necessary information needed for the authorizations.
• This position performs benefits checks for patients. This entails calling each patient's insurance provider to check deductible amounts and out of pocket amounts, confirming start and expiration dates, ensuring Department of Orthopedics providers are in network with patients' health plans, becoming aware of any limitations within the plan, and checking to see whether the insurance plan requires an authorization in order for the DME/orthotics to be covered.
• This position fields billing questions from internal and external customers.
• This position maintains positive relationships with key vendors and assists in onboarding of new vendors.
• This position will liaise with CU Medicine when pertinent.
• This position will receive calls from physician's offices, hospitals, patients, and insurance companies, using excellent customer service skills to maintain professionalism.
• This position will accurately enter required data into our computer database/EMR system.
• This position will review structured clinic data, matching it against medical terms and diagnosis/procedure codes.
• This position will attach incoming information to EMR/PM claims and follow established procedures for distributing information for further review.
• This position will refer any caller to benefit departments of correct claims administrator when requesting benefit information.
• This position will maintain Patient Confidentiality as defined by state, federal, and company regulations.
• This position will work to establish effective rapport with other employees, professional support staff, customers, clients, families, and physicians.

Other Duties

• Maintains a vast knowledge of the insurance world program.
• Actively support departmental and corporate strategic plans and ensure successful implementation.
• Support company and departmental QA/QI initiatives.
• Will take payments for cash pay/self-pay packages.
• May assist clinic and provider staff as necessary.

This description is a summary only and is describing the general level of work being performed, it is not intended to be all-inclusive. The duties of this position may change from time to time and/or based on business need. We reserve the right to add or delete duties and responsibilities at the discretion of the supervisor and/or hiring authority.

Minimum Qualifications

• A bachelor's degree in biological science, nutrition, nursing, health, human services, psychology, counseling, social work, or a directly related field from an accredited institution and 1 year of professional level experience in healthcare administration and insurance pre-authorization.

Substitution: A combination of education and related technical/paraprofessional experience may be substituted for the bachelor's degree on a year for year basis.

Preferred Qualifications

• Knowledge of medical service coding.
• Familiarity with medical terminology.
• One to three years of experience in prior authorizations particularly in DME or rehabilitation preferred.

Knowledge, Skills, and Abilities

• Ability to communicate effectively, both in writing and orally.
• 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.
• Demonstrated proficiency in keyboarding /computer use.
• Self-motivated and ability to work effectively in an independent environment.
• Provide quality customer service by being available for scheduled shifts. Includes arriving promptly and completing shifts as needed to meet demands of daily call levels.
• Excellent communication and organizational skills.
• Demonstrated ability to deal effectively with emotionally charged situations.
• Detail Orientation.
• Strong Organizational and task prioritization skills.
• Patient advocacy focus.
• Empathy.

Salary and Benefits

The salary range (or hiring range) for this position has been established at $55,911-$60,000.

The salary of the finalist(s) selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training.

The above salary range (or 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.

Benefits: https://www.cu.edu/employee-services/benefits

Total Compensation Calculator: http://www.cu.edu/node/153125

Diversity and Equity

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 hr.adacoordinator@ucdenver.edu​.



The University of Colorado Denver | Anschutz Medical Campus is committed to recruiting and supporting a diverse student body, faculty, and administrative staff. The university strives to promote a culture of inclusiveness, respect, communication and understanding. We encourage applications from women, ethnic minorities, persons with disabilities, persons within the LGBTQ+ community, and all veterans. The University of Colorado is committed to diversity and equality in education and employment.

The University of Colorado Denver | Anschutz Medical Campus is dedicated to ensuring a safe and secure environment for our faculty, staff, students, and visitors. To assist in achieving that goal, we conduct background investigations for all prospective employees.
Special Instructions to Applicants: Required Application Materials: To apply, please visit: http://www.cu.edu/cu-careers and attach: 1. A letter of application which specifically addresses the job requirements and outlines qualifications 2. A current CV/resume 3. List of three to five professional references (we will notify you prior to contacting both on and off-list references) Application Materials Required: Cover Letter, Resume/CV, List of References Application Materials Instructions: Application Deadline: Applications are accepted electronically ONLY at www.cu.edu/cu-careers. Application review will begin 1-2 weeks after date of posting and will continue until the position is filled. PLEASE NOTE: Candidates will be responsible for travel expenses related to the interview process and any relocation expenses, if applicable.

Job Category: Health Care

Primary Location: Aurora Department: U0001 -- DENVER & ANSCHUTZ MED CAMPUS - 20259 - SOM-ORTHO GENERAL OPERATIONS

Schedule: Full-time

Posting Date: Oct 26, 2022

Unposting Date: Ongoing Posting Contact Name: Thomas Roller Posting Contact Email: thomas.roller@cuanschutz.edu Position Number: 00803964





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