Prior Authorization Representative
About the Role
This position is responsible for accurately verifying and completing insurance eligibility, securing prior authorization, and managing authorization-related denials to ensure patient financial health. The role includes two weeks of in-person training in Murray, Utah, followed by fully remote work.
Shift: Monday - Friday, 11:00 AM to 7:30 PM. Shift differentials are provided for evenings, nights, and weekends.
Responsibilities
- Confirms, enters, and/or updates required demographic data on patient and guarantor.
- Accurately verifies all pertinent patient-related insurance eligibility, benefits, and authorization; follows up on appeals and denials when requested.
- Contacts patient/provider when authorization is unsecured prior to the scheduled date of service.
- Effectively escalates issues that 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.
Requirements
- Demonstrated experience in a healthcare revenue cycle role utilizing authorization tools.
- Basic understanding of medical terminology.
- Demonstrated experience in a customer service role.
- Strong attention to detail and accuracy.
- Basic understanding of healthcare billing and coding procedures.
Preferred Qualifications
- 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.
Skills
- Revenue Cycle
- Insurance Eligibility
- Office 365
- EMR Technology
- Customer service
- Time management
- Medical terminology
- Medical coding
- Accuracy
- Productivity
Physical Requirements
- Ongoing need to see and read information, labels, monitors, identify equipment and supplies, and assess customer needs.
- Frequent interactions with customers requiring clear communication and understanding of spoken information, alarms, needs, and issues.
- Manual dexterity to manipulate complex and delicate equipment with precision, including frequent computer, phone, and cable setup.
- For roles requiring driving: Ability to drive a vehicle, including sitting, seeing, and reading signs, traffic signals, and other vehicles.
Pay
The hourly range for this position is $18.85 - $25.61, dependent upon experience.
Benefits
Intermountain provides a comprehensive benefits package covering wellness programs for mind, body, and spirit, including health, happiness, security, connection, and engagement. Learn more about our benefits package here.
Location
This role is based in Murray, Utah, with scheduled weekly hours of 40.