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Prior Authorization Representative
IMHPrior authorization representative verifying insurance and managing denials for nonprofit Intermountain Health. Supporting patient financial health through authorization workflows, appeals, and revenue-cycle coordination.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in healthcare revenue cycle management, including patient authorization processes and insurance verification. Strong attention to detail and accuracy in handling demographic data and appeals management is essential.
Highest-signal resume keywords
Healthcare Revenue Cycle ExperienceAuthorization Tools ProficiencyMedical Terminology KnowledgeCustomer Service ExperienceEPIC Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Patient Insurance VerificationPrior Authorization ManagementHealthcare Billing ProceduresHealthcare Coding ProceduresData Entry Accuracy
Soft Skills
Attention to DetailProblem-SolvingCommunication Skills
Tools & Technologies
EPIC
Certifications & Qualifications
High School Diploma or Equivalent
Industry Keywords
HealthcareRevenue CycleDemographic DataAuthorization DenialsAppeals Management
About the role
Key responsibilities & impact- Confirm, enter, and/or update required demographic data on patients and guarantors
- Verify patient insurance eligibility, benefits, and authorization
- Secure prior authorization and manage authorization-related denials
- Follow up on appeals and denials when requested
- Contact patients or providers when authorization is unsecured before the scheduled date of service
- Escalate issues that cannot be resolved independently
- Maintain departmental and individual work queues
- Review work for self-quality and due diligence
- Meet or exceed departmental productivity, due diligence, and quality standards
Requirements
What you’ll need- Demonstrated experience in a healthcare revenue cycle role utilizing authorization tools
- Basic understanding of medical terminology
- Demonstrated experience in a customer service role
- Demonstrated experience in a role requiring strong attention to detail and accuracy
- Basic understanding of healthcare billing and coding procedures
- High School Diploma or Equivalent from an accredited institution (preferred)
- Two years of healthcare revenue cycle experience (preferred)
- Two years of experience in a customer-service related role (preferred)
- EPIC experience (preferred)
- Ability to work Monday–Friday, 8:00am–4:30pm
- Ability to perform required computer, phone, communication, visual, and manual-dexterity tasks
Benefits
Comp & perks- Generous benefits package covering programs supporting wellness, health, security, connection, and engagement
- PEAK program with up-front tuition coverage paid directly to the academic institution
- 100+ learning options through PEAK, including undergraduate studies, high school diplomas, and professional skills and certificates
- PEAK eligibility starting on day 1 of employment
- Remote work expectations include company equipment and work-schedule support for hybrid roles