Remote Prior Authorization Specialist - Utah

Utah; Salt Lake City (UT); Hybrid; USD 42,000 - 62,000; Full time

Job summary

University of Utah Health seeks a detail-oriented Insurance Verification Specialist to support outpatient services from a remote location within Utah. The role verifies eligibility, benefits and network status, and secures prior authorizations before services are provided by collaborating with physicians, nurses, schedulers, and financial advocates.

Ideal candidates have experience in medical insurance and prior authorizations, familiarity with ICD/CPT coding, and proficiency with Epic and

Qualifications

• Two years or more in a health care financial setting.
• Experience with medical insurance and prior-authorizations preferred.
• Familiarity with ICD/CPT coding is advantageous.

Responsibilities

• Verifies insurance eligibility, benefits, network status, and creates pre-service liability estimate.
• Ensures accurate ICD, CPT codes and related medical records are submitted in the authorization request.
• Secures prior authorizations for outpatient imaging and in office scheduled services.
• Acts as a liaison between the payer and clinic schedulers/medical support staff.
• Follows up on delayed or denied authorization requests and escalates for resolution.
• Creates detailed documentation and maintains/stores the authorization paper trail.
• May work to resolve claims denials related to the prior authorization.

Skills

Insurance verification

Prior authorizations

Tools

Epic ADT/Prelude

Cadence

Epicare

Referrals and Auth/Cert

Job description

University of Utah Health seeks a detail-oriented Insurance Verification Specialist to support outpatient services from a remote location within Utah. The role verifies eligibility, benefits and network status, and secures prior authorizations before services are provided by collaborating with physicians, nurses, schedulers, and financial advocates.

Ideal candidates have experience in medical insurance and prior authorizations, familiarity with ICD/CPT coding, and proficiency with Epic and