Prior Authorization Specialists - Hybrid after 6 months – Sandy, UT 84070

RemX | The Workforce Experts; Sandy (UT); Híbrido; USD 33 000 - 39 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Benefits package after conversion

Resumo da oferta

RemX | The Workforce Experts seeks a Prior Authorization Specialist in Salt Lake City. Hybrid role after 6 months, 9am-5pm, temp-to-hire with pay $24-$28/hour depending on experience.

You will manage 30+ active authorizations, review step therapy, appeals, and verify benefits while collaborating with providers, clinical teams, PACs, and sales reps. Training is two weeks onsite, first week classroom, second week shadowing; dress code is business casual.

Qualificações

• 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.
• Proficiency with EMRs, PMS and prior authorization systems.
• Strong experience with Salesforce, WeInfuse, and AMD.
• Excellent communication and customer service skills.
• Highly organized and multitasking skills.

Responsabilidades

• Processes prior authorizations accurately and efficiently, reviewing step therapy and payer requirements.
• Manages appeals and denials, escalating when necessary per payer protocols.
• Analyzes insurance policies and communicates with internal teams/providers for documentation.
• Verifies benefits and in-/out-of-network status across multiple payers; determines eligibility.
• Maintains clear, professional communication with providers, patients, internal teams.
• Documents all case-related conversations in Salesforce within required timeframes.
• Collaborates with team to gather/clarify case information; investigates complex cases.

Descrição da oferta de emprego

My client, a leader patient-centered infusion and specialty-care platforms company is hiring Prior Authorization Specialists to work in Salt Lake City .

This position manages prior authorizations to support timely patient care. The specialist collaborates with providers, clinical teams, PACs, and sales representatives while managing 30+ active authorizations. They track case progress, meet deadlines, and help ensure operational efficiency and patient satisfaction.

Pay: $24-$28, depending on experience

Type: Temp to hire

Location: Sandy, UT 84070 - hybrid or remote after 6 months (or sooner depends on performance).

Schedule: Monday-Friday 9AM to 5PM

Training: 2 weeks onsite. The first week is classroom, the second week is shadowing.

Dress Code: Business casual, nice jeans and top/blouse

Benefits

• Benefits through Remx and full package of benefits after converted to perm position.

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

Requirements

• Minimum 2-3 years of experience as a Medical Assistant (MA), with direct prior authorization
• Knowledge of commercial and Medicare Advantage policies, including Local Coverage Determinations (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