Revenue Cycle Representative; Prior Authorization - Patient Access Management; PAM - Patient

Position Summary

University of Iowa Health Care Department of Patient Financial Services is seeking a Prior Authorization Revenue Cycle Representative (RCR). The RCR is a financial clinical support healthcare position focused on delivering exceptional customer service and ensuring a seamless experience for patients, their families, insurance representatives, and our internal partners.

Supported by a culture of Service Excellence, the RCR will work in a high‑volume, web‑based application environment, performing prior authorization functions and insurance benefit coverage investigations. The role requires prioritization, multitasking, and empathy when collaborating with patients and staff.

Eligible for remote work within Iowa; remote eligibility is evaluated upon satisfactory completion of training. Training may occur onsite or via Zoom.

• Welcoming – an environment where everyone has a voice and is heard.
• Excellence – achieve and deliver our best in quality and accessible health care, education, and research.
• Collaboration – teamwork, guided by compassion.
• Accountability – ethical behavior, fairness, and responsibility.
• Respect – respect and safety for all community members.
• Empowerment – fair access to research, health care, and education, and opportunities for growth.

• Validate insurance eligibility, coverage details, network agreements, and financial obligations.
• Obtain, track, and complete prior authorizations, validating imaging, testing, and procedure medical necessity across specialties.
• Obtain appropriate clinical documentation from physicians and nurses to ensure accurate indications before third‑party authorizations.
• Address complex queries from clinical staff and insurer nurse reviewers; proactively contact third parties when necessary.
• Problem‑solve with utilization review nurses, medical directors, providers, and staff to meet patient care needs.
• Appeal denials and set up peer‑to‑peer reviews.
• Communicate with clinical teams about non‑covered procedures and facilitate financial counseling as directed.
• Assist with medical necessity documentation to expedite approvals and appeals.
• Use Epic to track prior authorizations, reviews, and denial follow‑up.
• Collaborate with other departments to obtain pre‑authorizations cross‑functionally.
• Maintain knowledge of medical modalities, new protocols, and payer regulations.
• Develop and maintain supportive working relationships across staff and external entities.
• Identify and report trends and reimbursement modeling errors.
• Maintain accuracy to meet productivity and quality standards.
• Analyze report data and provide status updates to leadership.
• Perform other duties as assigned.

Revenue Cycle Representative (Prior Authorization)

Prior Authorizations

Patient Financial Services

100%

2B

Hospital Support Services Building (HSSB) located in Coralville, IA

• Onsite – Workstation includes 3 monitors, laptop, docking station, keyboard, mouse, headset, and desk supplies.
• Hybrid – Onsite workstation same as above;
  Offsite requires employee to supply 2 monitors, keyboard, mouse, and provide a screenshot of domicile internet speed (≥30 mb download, ≥10 mb upload) and office setup photo.
• Remote – Office provided with laptop, docking station, headset; employee supplies 2 monitors, keyboard, mouse, and the same internet speed and photo requirements.

• Bachelor’s degree or equivalent combination of education and relevant experience.

• 6+ months of related customer service experience in a professional, financial or health‑care environment.
• Knowledge of healthcare billing, insurance, and federal/state assistance programs.
• Strong attention to detail and accuracy.
• Proficiency in Microsoft Office (Excel, Word, Outlook, PowerPoint) or comparable programs; quick learner of new systems.
• Ability to handle complex situations with minimal supervision.
• Self‑motivated and proactive in taking additional responsibilities.
• Effective written and verbal communication, active listening, and professionalism in demanding situations.
• Success collaborating in a…