Prior Authorization Specialist

RemX | The Workforce Experts; Salt Lake City (UT); On-site; USD 33,000 - 39,000; Full time

Benefits offered by this job

Hybrid or remote work after 6 months

Fully stocked breakroom with snacks

Business casual environment

Job summary

RemX | The Workforce Experts in Sandy, Utah is hiring 7-10+ Prior Authorization Specialists to support a growing healthcare team. You will process prior authorization requests, verify benefits, and manage appeals and denials.

The role offers a professional work environment with a fast hiring process. Hybrid or remote options may be available after training, with compensation between $24 and $28 per hour based on experience.

Qualifications

• Experience with insurance authorizations and approvals.
• Ability to review payer requirements and guidelines.
• Experience handling denials and appeals.
• Healthcare administration or medical office background.
• Strong documentation and attention to detail.

Responsibilities

• Process prior authorization requests accurately and efficiently.
• Review payer requirements, step therapy guidelines, and authorization criteria.
• Manage insurance denials and appeals while adhering to payer-specific protocols.
• Verify insurance benefits and determine in-network and out-of-network coverage.
• Evaluate medical and pharmacy benefits to determine patient eligibility for treatment.
• Analyze insurance policies and gather supporting documentation from providers when needed.
• Communicate professionally with healthcare providers, patients, payers, and internal teams.
• Maintain timely and accurate documentation within Salesforce and other systems.
• Ensure compliance with payer regulations and internal quality standards.

Skills

Prior Authorizations

Insurance Verification

Benefits Investigation

Appeals

Healthcare Administration

Tools

Salesforce

Job description

Salt Lake City (Sandy), Utah

Are you experienced in Prior Authorizations, Insurance Verification, Benefits Investigation, Appeals, or Healthcare Administration? We are actively hiring 7-10+ Prior Authorization Specialists to join a growing healthcare team in Sandy, Utah!

This is an excellent opportunity for candidates looking to work with a supportive team, enjoy a professional work environment, and build a long-term career with opportunities to transition into a hybrid or remote schedule.

Why Join Us?

Competitive pay: $24-$28 per hour based on experience and interview performance

Fast hiring process with onsite interview events

Hybrid or remote work after 6 months

Remote opportunities may be considered after training for highly qualified candidates

Fully stocked breakroom with complimentary snacks and beverages

Business casual environment

Schedule

• Monday-Friday
• 9:00 AM - 5:00 PM

Training

• Week 1: Classroom training
• Week 2: Job shadowing and hands-on learning

Key Responsibilities

• Process prior authorization requests accurately and efficiently.
• Review payer requirements, step therapy guidelines, and authorization criteria.
• Manage insurance denials and appeals while adhering to payer-specific protocols.
• Verify insurance benefits and determine in-network and out-of-network coverage.
• Evaluate medical and pharmacy benefits to determine patient eligibility for treatment.
• Analyze insurance policies and gather supporting documentation from providers when needed.
• Communicate professionally with healthcare providers, patients, payers, and internal teams.
• Maintain timely and accurate documentation within Salesforce and other systems.
• Ensure compliance with payer regulations and internal quality standards.

Ideal Candidate Qualifications

Insurance Verification or Benefits Investigation experience

Appeals and Denials experience preferred

Healthcare, specialty pharmacy, medical office, or insurance background

Strong attention to detail and documentation skills

Ability to review and interpret insurance policies

Experience navigating multiple payer systems

Excellent communication and customer service skills

Salesforce experience is a plus

Positions are expected to fill quickly, and selected candidates can start as soon as possible.