Prior Authorization & Eligibility Specialist I

Intermountain Healthcare Inc.; Broomfield (CO); On-site; USD 27,000 - 39,000; Full time

Job summary

Intermountain Health is seeking a Pre-Access Authorization Specialist I to verify insurance eligibility, obtain prior authorizations, and manage related denials to protect patient financial health. This role supports accurate demographic entry, data integrity, and effective escalation when issues arise in a fast-paced environment.

Responsibilities include communicating with patients and providers before scheduled services, maintaining queues, meeting productivity and quality standards, and

Qualifications

• High school diploma or equivalent required for consideration or 4 years of revenue cycle experience.
• Minimum of 2 years insurance authorization experience required.

Responsibilities

• Confirms, enters, and/or updates required demographic data on patient and guarantor
• Accurately verifies all pertinent patient related insurance eligibility, benefits, authorization; follow-up on appeals and denials when requested
• Contacts patient/provider when authorization is unsecured prior to scheduled date of service
• Effectively escalates issues which cannot be resolved independently
• Maintains departmental/individual work queues and reviews self-quality for due diligence
• Meets or exceeds departmental productivity, due diligence and quality standards
• Promotes mission, vision, and values and abides by service behavior standards

Skills

Revenue cycle knowledge

Technical/technology acumen

Customer service

Time management

Medical terminology

Medical coding

Competency proficiency

Education

High School Diploma/Equivalent

4 years revenue cycle experience

Job description

Intermountain Health is seeking a Pre-Access Authorization Specialist I to verify insurance eligibility, obtain prior authorizations, and manage related denials to protect patient financial health. This role supports accurate demographic entry, data integrity, and effective escalation when issues arise in a fast-paced environment.

Responsibilities include communicating with patients and providers before scheduled services, maintaining queues, meeting productivity and quality standards, and