University of Iowa · 5 days ago
Revenue Cycle Representative (Hybrid) Offsite
Iowa City, IA
Full-time
Hybrid
New Grad, Entry LevelThe University of Iowa is seeking a Pharmacy Prior Authorization Revenue Cycle Representative to support patients in obtaining insurance coverage for outpatient pharmacy medications. This role involves performing benefits investigations, providing prior authorization support, and researching patient financial assistance options while ensuring timely access to medications.
EducationHigher EducationUniversities
Responsibilities
Assist patients and staff with benefits investigation and enrollment of patients into pharmacy services (i.e. specialty pharmacy)
Communicate with patients, pharmacists and/ or providers to gather relevant demographic information
Initiate and follow through for required prior authorizations, which may include pharmacy or medical authorizations
Assist clinical pharmacy specialists or other providers with initiation of appeals when applicable
Assist with copay/coinsurance assistance when applicable
Communicate with patients, insurance companies, credit/collections for payment acquisition, pre-authorization and to resolve patient account inquiries
Appeal/troubleshoot claim payments and/or denials using available resources
Provide accurate documentation of all activities as required by accrediting agencies, payers and/or administration
Monitor reimbursement activity for medications to ensure UI Health Care receives full and accurate reimbursement for pharmacy services in compliance with payor rules and regulations
Monitor compliance standards and policies to ensure UI Health Care receives full and accurate reimbursement for services in compliance with payor rules and regulations
Assist with the resolution of patient shipment issues in a timely manner
Provide refill management calls and follow up to Specialty Pharmacy patients when assigned
Assist Specialty Pharmacy and external pharmacy staff with the resolution of claims issues
Provide the highest customer service experience for patients and providers
Utilize tools and processes to maximize the efficiency of the revenue cycle
Resolve pharmacy billing discrepancies and identify possible trends
Identify areas to improve the billing process
Identify areas to improve the benefits investigation and prior authorization process
Comply with established cash handling policies and procedures of the institution and department
Assist with the evaluation and implementation of new products/technology
Assist with the evaluation and implementation of new policies and procedures
Participate in standard pharmacy operations as the need arises
Analyze and prepare routine reports to identify trends and aid in making financial decisions
Compile information for audits as they arise from compliance and insurance/third party payors in a reportable manner
Report discrepancies found during report analysis
Document activities required by accrediting agencies, payors and/or administration (i.e. workload statistics, phone statistics, etc.)
Communicate with providers, payors, patients, co-workers, supervisors and departments to resolve revenue cycle issues
Understand the importance of effective business communication and maintaining professionalism in difficult situations
Participate in orientation of pharmacy technicians, pharmacists, pharmacy residents and others within the department on pharmacy billing practices
Complete and maintain compliance with all competencies and educational requirements
Other duties as assigned
Qualification
Required
Completion of a Bachelor's degree or equivalent combination of education and experience
Successful completion of the pharmacy technician certification exam within twelve months of the start of employment
Previous experience in customer service
Experience and proficiency with computer software applications (i.e. Microsoft Office Suite – Word, Excel, Outlook, PowerPoint) or comparable programs
Strong attention to detail and proven ability to gather and analyze data and keep accurate records
Self-motivated with initiative to seek out additional responsibilities and tasks along with generating suggestions for improving workflow
Effective verbal and written communication skills, active listening skills and the ability to maintain professionalism while handling difficult situations
Demonstrate effective problem solving abilities and meets challenges with resourcefulness
Familiarity with medical terminology
Preferred
Experience working in a complex hospital system is highly desirable
Experience working in a collaborative team environment is desirable
Pharmacy experience is desirable
Knowledge of healthcare billing, experience working with insurance and/or federal and state assistance programs is desirable
Experience working with multiple technology platforms (i.e. Epic, GE) is desirable
Knowledge and understanding of the Health Insurance Portability and Accountability Act (HIPAA) is desirable
Professional experience working effectively with individuals from a variety of backgrounds and perspectives
Company
University of Iowa
On our beautiful campus spanning the Iowa River, our faculty and staff enjoy access to an array of cultural, educational, and recreational activities.
Founded in 1986
10001+ employees
H1B Sponsorship
University of Iowa has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (353)
2024 (300)
2023 (244)
2022 (217)
2021 (201)
2020 (193)
Funding
Current Stage
Late StageTotal Funding
$2.5MKey Investors
Windgate Foundation
2022-08-17Grant· $2.5M
Leadership Team
Kurt H.
Assoc. Professor, E-MBA Business, UI College of Business; Advised 300 companies globally, CEO
Vince Nelson
President & CEO
Recent News
Corridor Business Journal
2025-07-11
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2025-04-09
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2025-02-20
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