Authorization Representative

Job Description: This position is responsible to obtain insurance eligibility and benefits information and obtain required authorizations. Reviews all insurance eligibility responses and communicates with the physician's office and insurance companies as needed regarding these responses or to obtain correct information. Works with Utilization Review staff to ensure authorizations cover services needed. May also estimate cost of service and patient's responsibility. Refers patients with questionable insurance coverage to the Eligibility Counselors. May assist in mentoring new hires.Job Essentials 1. Obtains insurance eligibility and benefit information using various phone and on-line resources. 2. Obtains appropriate authorizations and notifies insurance companies of patient arrival as needed. 3. Works with Utilization Review staff and/or physicians' offices to assure eligibility and authorization requirements are completed within the required timeframe. 4. Communicates with the appropriate nursing and/or billing staff when changes are made to the account that will affect the reimbursement. 5. Makes appropriate corrections in the patient's record to ensure accuracy in order to prevent denials and/or problems with billing and reimbursement. 6. Immediately refers 'at risk' admission to eligibility, i.e., out of network, underinsured, max benefits, etc. 7. Works with insurance eligibility responses and other appropriate reports and works with physicians and patients as needed to resolve issues and prevent billing delays. 8. Maintains a satisfactory level of performance and adherence to workload standards. 9. Estimates cost of service using ICD-9 or CPT codes. 10. Interprets 271 response, including insurance terminology, in online tool to determine patient responsibility. 11. Performs calculations using insurance benefit information to accurately estimate patient responsibility. 12. May lead and/or train new employees in account preparation and review functions. Minimum Qualifications Two years of customer service experience. - and - Demonstrated good communications and computer skills. Preferred Qualifications Demonstrated knowledge of medical terminology. - and - Experience in admitting, billing, collections, and/or insurance verification. - and - Bi-Lingual Spanish speaking. - and - Demonstrated knowledge of CPT/ICD-9 codes. Interact with others requiring the employee to communicate information. - and - Operate computers and other office equipment requiring the ability to move fingers and hands. - and - See and read computer monitors and documents. - and - Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment. Location: Home Services - Salt Lake City Work City: South Jordan 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. Headquartered in Utah with locations in six primary states and additional operations across the western U.S., Intermountain Health is a nonprofit system of 34 hospitals, 400+ clinics, a medical group of more than 4,800 employed physicians and advanced care providers, a health plan division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and efficient healthcare delivery. Join our world-class team and embark on a career filled with opportunities, strength, innovation, and fulfillment. To find out more about us, head to our career site here. Sign up for job alerts! Click sign in at the top right corner, create a candidate account, and when we have opportunities that meet your interests, you will receive an email with the job details. Intermountain Health strives to make the application process accessible to all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact 1-800-843-7820 or email recruitment@imail.org. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications. Introduce yourself to our Talent Acquisition team and we will get in touch if there is a role that seems like a good match. Intermountain Healths PEAK program supports caregivers in the pursuit of their education goals and career aspirations by providing up-front tuition coverage paid directly to the academic institution. The program offers 100+ learning options to choose from, including undergraduate studies, high school diplomas, and professional skills and certificates. Caregivers are eligible to participate in PEAK on day 1 of employment. Learn more. The primary intent of this job description is to set a fair and equitable rate of pay for this classification. Only those key duties necessary for proper job evaluation and/or labor market analysis have been included. Other duties may be assigned by the supervisor. All positions subject to close without notice. Thanks for your interest in continuing your career with our team!