Intermountain Health
Prior Authorization Representative
Intermountain Health, Murray, Utah, United States,
Job Description:
Responsible for obtaining prior authorizations for patients and physician offices. Obtains and inputs all necessary demographic, financial, and clinical information from the patient, representative or physicians office. This position will also fill in as a Patient Service Representative as needed, checking in patients and verifying patient information.
This position will be partially remote with in-person training and some in-person coverage required as needed. Candidate needs to live in service area.
Scope
This position performs prior authorizations for patients and physician offices and is part of a collaborative work team. The incumbent works and communicate directly with appropriate clinical services, insurance companies. The incumbent obtains prior authorizations at multiple facilities within the region. The position reports to the Regional Scheduling Manager.
Job Essentials
Verifies the accuracy of EMPI link, and identifies and reports possible identity theft.
Interacts with patients, physicians, office staff, or representatives to obtain required authorization information.
Interacts with insurance payers to provide essential information for pre-authorization.
Inputs authorization information, patient demographic data, insurance carrier information, and other essential admission information into a database so that appropriate billing, reporting, and analysis can be performed by facility, corporate, state and federal agencies.
Provides explanations of legal documents to customers in accordance with regulatory requirements.
Maintains performance measures determined reasonable for the position.
May lead and/or train new employees.
Minimum Qualifications
Three years customer service experience within the last five years.
Demonstrated ability to work effectively in time sensitive situations, manage multiple priorities effectively, and to make prompt, responsible decisions.
Demonstrated computer proficiency.
Preferred Qualifications
Bi-lingual Spanish speaking.
Data entry or clerical experience in a medical office setting within the last three years.
Negotiation or collection experience within the last three years.
Demonstrated knowledge of medical terminology.
Experience with Intermountain scheduling or RCO functions.
Physical Requirements:
Interact with others requiring the employee to communicate information.
Operate computers and other office equipment requiring the ability to move fingers and hands.
See and read computer monitors and documents.
Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.
Anticipated job posting close date:
06/17/2024
Location:
Intermountain Medical Center
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.
$17.68 - $24.02
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 packages for our Idaho, Nevada, and Utah based caregivers (https://intermountainhealthcare.org/careers/working-for-intermountain/employee-benefits/) , and for our Colorado, Montana, and Kansas based caregivers (http://www.sclhealthbenefits.org) ; and our commitment to diversity, equity, and inclusion (https://intermountainhealthcare.org/careers/working-for-intermountain/diversity/) .
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.
Responsible for obtaining prior authorizations for patients and physician offices. Obtains and inputs all necessary demographic, financial, and clinical information from the patient, representative or physicians office. This position will also fill in as a Patient Service Representative as needed, checking in patients and verifying patient information.
This position will be partially remote with in-person training and some in-person coverage required as needed. Candidate needs to live in service area.
Scope
This position performs prior authorizations for patients and physician offices and is part of a collaborative work team. The incumbent works and communicate directly with appropriate clinical services, insurance companies. The incumbent obtains prior authorizations at multiple facilities within the region. The position reports to the Regional Scheduling Manager.
Job Essentials
Verifies the accuracy of EMPI link, and identifies and reports possible identity theft.
Interacts with patients, physicians, office staff, or representatives to obtain required authorization information.
Interacts with insurance payers to provide essential information for pre-authorization.
Inputs authorization information, patient demographic data, insurance carrier information, and other essential admission information into a database so that appropriate billing, reporting, and analysis can be performed by facility, corporate, state and federal agencies.
Provides explanations of legal documents to customers in accordance with regulatory requirements.
Maintains performance measures determined reasonable for the position.
May lead and/or train new employees.
Minimum Qualifications
Three years customer service experience within the last five years.
Demonstrated ability to work effectively in time sensitive situations, manage multiple priorities effectively, and to make prompt, responsible decisions.
Demonstrated computer proficiency.
Preferred Qualifications
Bi-lingual Spanish speaking.
Data entry or clerical experience in a medical office setting within the last three years.
Negotiation or collection experience within the last three years.
Demonstrated knowledge of medical terminology.
Experience with Intermountain scheduling or RCO functions.
Physical Requirements:
Interact with others requiring the employee to communicate information.
Operate computers and other office equipment requiring the ability to move fingers and hands.
See and read computer monitors and documents.
Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.
Anticipated job posting close date:
06/17/2024
Location:
Intermountain Medical Center
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.
$17.68 - $24.02
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 packages for our Idaho, Nevada, and Utah based caregivers (https://intermountainhealthcare.org/careers/working-for-intermountain/employee-benefits/) , and for our Colorado, Montana, and Kansas based caregivers (http://www.sclhealthbenefits.org) ; and our commitment to diversity, equity, and inclusion (https://intermountainhealthcare.org/careers/working-for-intermountain/diversity/) .
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.