Top 24 Prior authorization specialist Jobs in Midvale, Ut

Prior Authorization Specialist
Pure Infusion —Sandy, UT
- $24 - $28 an hour
- Full-time
- Mid-level
- High school diploma or GED
- Neurology
Quick Apply
Intake Specialist - Prior Authorization
JQ MEDICAL —Midvale, UT
- $20 - $23 an hour
- Full-time
- Customer service
- HIPAA
- Mid-level
- Paid holidays
- Dental insurance
Insurance Authorizations Specialist
The Orthopedic Partners —Salt Lake City, UT
- Full-time
- Computer literacy
- Microsoft Office
- High school diploma or GED
Quick Apply
Intake Specialist (In-Office if Local / Remote if Non-Local)
UNITED WOUND HEALING PS —Salt Lake City, UT
- $19 - $23 an hour
- Overtime
- Microsoft Outlook
- Pass drug screening
- HIPAA
- AD&D insurance
- Paid holidays
Quick Apply
Insurance Verification & Authorization Specialist – Remote
FYZICAL LLC —Lehi, UT
- $17 - $19 an hour
- Full-time
- Remote
- Microsoft Outlook
- Addiction Medicine
- Mid-level
- Paid holidays
- Disability insurance
Quick Apply
Authorization Specialist
Home Helpers Home Care —South Salt Lake, UT
- $55,000 - $65,000 a year
- 8 hour shift
- Microsoft Outlook
- Mid-level
- 3 years
- Paid training
- Paid holidays
Quick Apply
Intake Specialist, Infusion Clinics
Option Care Health —Murray, UT
- $16.61 - $26.96 an hour
- Full-time
- Computer literacy
- 3 years
- High school diploma or GED
- Health savings account
- Health insurance
Behavioral Health Utilization/Authorization Specialist
Threshold Billing Solutions —Sandy, UT
- $47,000 - $57,000 a year
- Full-time
- Google Workspace
- Addiction Medicine
- Licensed Clinical Social Worker
- Disability insurance
- Health insurance
Quick Apply
Insurance Verification Specialist
Gadjab —Lehi, UT
- $22 an hour
- Part-time
- Mid-level
- Office
- Computer skills
Quick Apply
4h
Patient Services Specialist
University of Utah Health —South Jordan, UT
- Full-time
- Microsoft Outlook
- Pass drug screening
- Mid-level
- Retirement plan
9d
Patient Services Specialist - Neurosurgery
University of Utah Health —Salt Lake City, UT
- Full-time
- Microsoft Outlook
- Pass drug screening
- Mid-level
- Retirement plan
2d
Patient Services Specialist - CNC
University of Utah Health —Salt Lake City, UT
- Full-time
- Microsoft Outlook
- Pass drug screening
- Mid-level
- Retirement plan
2d
Intake Specialist
Canyon Home Care & Hospice LLC —Salt Lake City, UT
- Full-time
- HIPAA
- Mid-level
- High school diploma or GED
Quick Apply
PS Outpatient Svcs. Specialist
University of Utah Health —Salt Lake City, UT
- $22.57 an hour
- Full-time
- Surgery
- Pass drug screening
- Outpatient experience
- On-the-job training
- Retirement plan
PS Outpatient Svcs. Specialist
University of Utah —Salt Lake City, UT
- $22.57 an hour
- Full-time
- Surgery
- Pass drug screening
- Outpatient experience
- On-the-job training
- Retirement plan
Denials and Appeals Specialist (on-site/hybrid)
FixMyClaim —Salt Lake City, UT
- $23 - $28 an hour
- Full-time
- Hybrid work
- Writing skills
- HIPAA
- Mid-level
- Health savings account
- Health insurance
Quick Apply
13h
Medical Billing Specialist
Rocky Mountain Retina Consultants, LLC —Salt Lake City, UT
- Full-time
- Private practice
- Communication skills
- Entry level
- Profit sharing
- Disability insurance
Quick Apply
Medical Coding & Billing Specialist
Stella Mental Health —Murray, UT
- $20 - $23 an hour
- Full-time
- HIPAA
- Mid-level
- Clinic
- Paid holidays
- Health insurance
Quick Apply
Lead Medical Billing Specialist
Rocky Mountain Retina Consultants —Millcreek, UT
- From $24.13 an hour
- Full-time
- Mid-level
- In-person
- Communication skills
- Paid holidays
- Health insurance
Quick Apply
Lead Medical Biller
Rocky Mountain Retina Consultants, LLC —Salt Lake City, UT
- Mid-level
- Communication skills
- Commercial
- Paid holidays
- Paid time off
Quick Apply

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Prior Authorization Specialist

Pure Infusion -
Sandy, UT

Quick Apply

Job Details

Full-time
$24 - $28 an hour

Qualifications

Customer communication
Medicare
Medical insurance coverage verification
Patient management software
High school diploma or GED
Salesforce Cloud
Pre-authorization review for utilization management
Medicare regulations
Clinical information systems
Policy verification in claims processing
Sales management systems proficiency
Insurance policy review
Patient interaction
Medical assisting
CRM system proficiency
Customer service problem-solving
Documentation review
Technical Proficiency

Full Job Description

About PURE

Pure Infusion Suites is a fast-growing healthcare start-up, recognized as the fastest-growing company in Utah as of October 2024. Our success comes from our remarkable team, shared values, and a supportive culture that shows in every interaction, whether with patients in our clinics or with insurance companies and vendors at our corporate headquarters. If you are detail-oriented, self-directed, and passionate about ensuring claims are processed quickly and accurately, this could be the perfect role for you.

OUR CORE VALUES
We live by four core values that define our culture and guide our hiring:

People-obsessed
Passionate
Builder
Grateful

Position Summary:
The Prior Authorization Specialist is a vital team member responsible for efficiently managing the prior authorization process to ensure seamless patient care and timely treatment. This position requires a solid understanding of medical benefits, step therapy, and authorization policies, along with exceptional organizational, communication, and problem-solving skills. The role involves consistent collaboration with providers, clinical teams, local PACs, and sales representatives, requiring outstanding professionalism and multitasking abilities.

The Specialist will manage a caseload of at least 30 active authorizations and must skillfully navigate systems such as Salesforce, WeInfuse, and AMD to track and update case progress, send communications, and meet critical deadlines. This role is key to maintaining operational efficiency and directly contributes to Pure’s standard of excellence and patient satisfaction.

Key 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 follows appropriate payer protocols.
Analyzes insurance policies for each case and communicates with internal teams or providers to obtain needed documentation when the case does not align with policy.
Verifies insurance benefits and determines in-network (INN) or out-of-network (OON) status across various payers and states under Intake standards.
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.
Prioritizes personal tasks and authorizations to ensure timely completion and follow-up.
Collaborates with internal team members (e.g., PACs, clinical staff, sales) to gather or clarify case information.
Investigates and resolves complex cases using strong critical thinking and problem-solving skills.
Organizes and manages authorization workload efficiently to meet performance goals.
Follow and produce by Intake standards for accuracy and completion standards.

Required Knowledge and Skills

Minimum 2-3 years of experience as a Medical Assistant (MA), with direct prior authorization and biologic therapy experience.
Proven ability to interpret clinical documentation and understand commercial and Medicare Advantage policies, including Local Coverage Determinations (LCDs).
Strong experience working with systems like Salesforce, WeInfuse, and AMD.
Background in a specialty field such as Rheumatology, Gastroenterology, Dermatology, Neurology, or Immunology preferred.
Excellent communication and customer service skills with both clinical teams and patients.
Highly organized and capable of managing multiple priorities in a fast-paced environment.
Strong documentation habits and time management skills.

Education/Licensure/Technical Requirements
High School diploma or equivalent required.
Certification or formal training as a Medical Assistant required
Biologic Authorization experience required
Must meet U.S. employment eligibility requirements.
Proficiency with EMRs, CRMs (Salesforce), and prior authorization systems.
Works comfortably in software like a PMS or EMR to track information, schedule and make notes.
Ability to meet U.S. employment and eligibility requirements

The pay range for this role is:
24 - 28 USD per hour(Sandy HQ)

Quick Apply

Refine Your Search

prior authorization specialist jobs in midvale, ut

Prior Authorization Specialist

Intake Specialist - Prior Authorization

Insurance Authorizations Specialist

Intake Specialist (In-Office if Local / Remote if Non-Local)

Insurance Verification & Authorization Specialist – Remote

Authorization Specialist

Intake Specialist, Infusion Clinics

Behavioral Health Utilization/Authorization Specialist

Insurance Verification Specialist

Patient Services Specialist

Patient Services Specialist - Neurosurgery

Patient Services Specialist - CNC

Intake Specialist

PS Outpatient Svcs. Specialist

PS Outpatient Svcs. Specialist

Denials and Appeals Specialist (on-site/hybrid)

Medical Billing Specialist

Medical Coding & Billing Specialist

Lead Medical Billing Specialist

Lead Medical Biller

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