Prior Authorization Representative

Jobtailor; Murray (UT); On-site; USD 42,000 - 60,000; Full time

Job summary

Jobtailor is seeking a detail-oriented Revenue Cycle Specialist to support patient and guarantor data, verify insurance eligibility, and manage prior authorizations in a fast-paced healthcare setting in Murray, UT.

The role requires accuracy, familiarity with authorization processes, and experience with EPIC; standard hours are Mon-Fri 8:00am–4:30pm with a focus on denials, appeals, and improving reimbursement outcomes.

Qualifications

• Two years of healthcare revenue cycle experience (preferred).
• Basic understanding of medical terminology.
• Demonstrated customer service experience.
• Experience in healthcare billing and coding procedures (preferred).
• EPIC experience (preferred).

Responsibilities

• Confirm, enter, and 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 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.

Skills

Healthcare Revenue Cycle

Authorization Tools Proficiency

Medical Terminology Knowledge

Customer Service Experience

Attention to Detail

Education

High School Diploma or Equivalent

Tools

EPIC

Job description

• 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

• 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

Core Competencies

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 Experience
• Authorization Tools Proficiency
• Medical Terminology Knowledge
• Customer Service Experience
• EPIC Experience

Hard Skills

• Patient Insurance Verification
• Prior Authorization Management
• Healthcare Billing Procedures
• Healthcare Coding Procedures
• Data Entry Accuracy

Soft Skills

• Attention to Detail
• Problem-Solving
• Communication Skills

Certifications & Qualifications

• High School Diploma or Equivalent

Industry Keywords

• Healthcare
• Revenue Cycle
• Demographic Data
• Authorization Denials
• Appeals Management

Tools & Technologies

• EPIC