Prior Authorization Representative

Pre-Access Authorization Specialist I

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
• Productivity

Qualifications

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.

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.