Prior Authorization Representative

Intermountain Health; United States; Hybrid; USD 26,000 - 34,000; Full time

Job summary

Intermountain Health seeks a Pre-Access Authorization Specialist I to verify insurance eligibility, obtain prior authorizations, and manage denials to protect patient financial health.

The role includes maintaining demographic data, communicating with patients and providers, escalating unresolved issues, and meeting productivity and quality standards. In-person training occurs in Murray, Utah, with full remote work after training.

Qualifications

• Demonstrated experience in a healthcare revenue cycle role utilizing authorization tools.
• Demonstrates basic understanding of medical terminology.
• Demonstrated experience in a customer service role.
• Demonstrated experience in a role requiring strong attention to detail and accuracy.
• Demonstrates basic understanding of healthcare billing and coding procedures.

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

Skills

Revenue Cycle

Insurance Eligibility

Office 365

EMR Technology

Customer service

Time management

Medical terminology

Medical coding

Accuracy

Productivity

Education

High School Diploma or Equivalent

Tools

EPIC

Job description

The Pre-Access Authorization Specialist I is responsible for accurately verifying and completing insurance eligibility, securing prior authorization and managing authorization related denials to ensure patient financial health.

Posting Specifics

• Benefits Eligible: Yes
• Shift Details: Monday - Friday 11am to 7:30pm
• Additional Details: Shift differentials given for evenings, nights and weekends

Two weeks of in person training in Murray, Utah and then fully remote after training.

Essential Functions

• 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

Skills

• Revenue Cycle
• Insurance Eligibility
• Office 365
• EMR Technology
• Customer service
• Time management
• Medical terminology
• Medical coding
• Accuracy
• ProductivityQualifications

Required

• Demonstrated experience in a healthcare revenue cycle role utilizing authorization tools.
• Demonstrates basic understanding of medical terminology.
• Demonstrated experience in a customer service role.
• Demonstrated experience in a role requiring strong attention to detail and accuracy.
• Demonstrates basic understanding of healthcare billing and coding procedures.

Preferred

• High School Diploma or Equivalent from an accredited institution. Education is verified.
• Two (2) years of healthcare revenue cycle experience.
• Two (2) years of experience in a customer-service related role.
• EPIC experience.

Physical Requirements

• Ongoing need for employee to see and read information, labels, monitors, identify equipment and supplies, and be able to assess customer needs.
• Frequent interactions with customers require employees to communicate as well as understand spoken information, alarms, needs, and issues quickly and accurately.
• Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer, phone, and cable set-up and use.
• For roles requiring driving: Expected to drive a vehicle which requires sitting, seeing and reading signs, traffic signals, and other vehicles.

Location:

TOSH

Work City:

Murray

Work State:

Utah

Scheduled Weekly Hours:

40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

• $18.85 - $25.61

We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits package here.

By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. I further acknowledge that outside employment or activities may not interfere with job responsibilities or create a conflict of interest with Intermountain. Actual or reasonably perceived conflicts may be grounds for disqualification from consideration or, if hired, corrective action up to and including termination of employment.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.

All positions subject to close without notice.