Prior Authorization Representative I

Job Description:

A Prior Authorization Representative is a critical link in the healthcare chain that balances the needs of patients, healthcare providers, and insurance companies. They provide cost-containment measures and improved patient outcomes by verifying ordered medical services are medically necessary, making certain insurance & healthcare provider policies are complied with, advocating for the patients’ best interests, and removing the administrative burden from healthcare providers so they can focus on patient care. Facilitates the authorization process for 1-2 lines of service by gathering and submitting all required clinical documentation, medical records, and insurance forms.
Communicates with healthcare providers, insurance companies, and patients/guarantors to initiate and follow up on authorization requests.
Provides guidance and support to patients/guarantors and healthcare providers navigating the authorization process. Coordinates first-level appeals and coordinates peer-to-peer reviews for prior authorization denials.

Schedule - Monday - Friday 7 am - 5 pm

Minimum Requirements

• Two years patient service experience in a clinical setting within the last 5 years.
• Demonstrated ability to work effectively in time-sensitive situations, manage multiple priorities effectively, and make prompt, responsible decisions.
• Demonstrated computer proficiency.
• Demonstrated excellent interpersonal and communication skills.
• Demonstrated ability to prioritize multiple tasks.
• Demonstrated typing proficiency & working knowledge of word processing, spreadsheet, email, and calendaring programs

Preferred Qualifications

• Bi-lingual Spanish speaking.
• Data entry or clinical experience in a medial office setting in the last 5 years.
• Negotiation or collection experience in the last 3 years.
• Demonstrated knowledge of medical terminology
• Experience with Intermountain scheduling or RCO functions within the last 3 years.

Physical Requirements:

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.

Location:

Intermountain Health Utah Valley Hospital

Work City:

Provo

Work State:

Utah

Scheduled Weekly Hours:

40

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

$18.39 - $24.99

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.

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.