Prior Authorization Specialist — Hybrid/Remote (Utah)

RemX | The Workforce Experts; Sandy (UT); Hybrid; USD 33,000 - 39,000; Full time

Benefits offered by this job

Benefits through RemX

Full benefits after conversion to perm

Job summary

RemX | The Workforce Experts client in Salt Lake City is hiring a Prior Authorization Specialist for a hybrid/remote-capable role after an initial on-site training period.

You will manage payer authorizations, collaborate with providers and clinical teams, track 30+ active cases, meet deadlines, and document all steps in Salesforce and payer systems to support timely patient care. Training is 2 weeks on site; schedule Mon–Fri 9–5; benefits available after conversion.

Qualifications

• Minimum 2-3 years of experience as a Medical Assistant (MA), with direct prior authorization.
• Knowledge of commercial and Medicare Advantage policies, including LCDs.
• High School diploma or equivalent required.
• Proficiency with EMRs, PMS and prior authorization systems
• Strong experience working with systems like Salesforce, WeInfuse, and AMD.
• Excellent communication and customer service skills
• Highly organized and multitasking skills.

Responsibilities

• Processes prior authorizations accurately and efficiently, including reviewing step therapy, minimum authorization requirements, and payer-preferred medications.
• Manages appeals and denials, escalating cases when necessary, and following appropriate payer protocols.
• Analyzes insurance policies for each case and communicates with internal teams or providers to obtain needed documentation
• Verifies insurance benefits and determines in-network or out-of-network status across various payers and states
• Evaluates medical and pharmacy benefits to determine patient eligibility for treatment.
• Maintains clear, professional communication with providers, patients, internal teams, and stakeholders.
• Accurately documents all case-related conversations and updates within Salesforce within required timeframes.
• Collaborate with internal team members to gather or clarify case information.
• Investigates and resolves complex cases

Skills

Prior Authorization

Medical Assistant

Communication

Organization

Education

High School diploma

Tools

Salesforce

WeInfuse

EMRs

PMS

AMD

Job description

RemX | The Workforce Experts client in Salt Lake City is hiring a Prior Authorization Specialist for a hybrid/remote-capable role after an initial on-site training period.

You will manage payer authorizations, collaborate with providers and clinical teams, track 30+ active cases, meet deadlines, and document all steps in Salesforce and payer systems to support timely patient care. Training is 2 weeks on site; schedule Mon–Fri 9–5; benefits available after conversion.