Prior Authorization Specialist — Hybrid/Remote After Training

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

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.