Director Prior Authorization Representative Express Scripts Jobs

Hybrid Work

TOSH

Full time

R180966

Job Description:

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.

Learn more about our comprehensive benefits package here (https://intermountainhealthcare.org/careers/benefits) .

By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. I further acknowledge that outside employment or activities may not interfere with job responsibilities or create a conflict of interest with Intermountain. Actual or reasonably perceived conflicts may be grounds for disqualification from consideration or, if hired, corrective action up to and including termination of employment.

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 (https://intermountainhealthcare.org/careers/?utm_source=Workday&utm_medium=Redirect&utm_campaign=CareerHome_workday) .

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 Health's 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. (https://intermountainhealthcare.org/careers/working-for-intermountain/employee-benefits/peak-program/)

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!