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Job Summary
This position is responsible for securing outpatient accounts by performing insurance verification, obtaining benefit information, calculating patient estimates, and obtaining prior authorization before services are rendered. It works with physicians, nurses, clinic managers and financial advocates to resolve issues that arise during the prior authorization process. This role does not provide direct patient care.
Eligible for work‑from‑home and/or hybrid work options; may be required on‑site during the training period.
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 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 prior authorization.
Knowledge / Skills / Abilities
Basic knowledge of accounting, word processing and spreadsheets.
Critical thinking and ability to analyze information and problem‑solve.
Professional verbal and written communication skills.
Ability to work independently within a team setting.
Adaptability to a dynamic work environment.
Prioritization and workload management under stress.
Multitasking ability.
Familiarity with human anatomy and medical terminology.
High level of detail and accuracy in work.
Meeting process time standards.
Professional and courteous service to internal and external customers.
Navigation through various hospital software applications, including Epic ADT/Prelude, Cadence, Epicare, Referrals and Auth/Cert applications.
Navigation of multiple web sites.
Qualifications
Minimum Qualifications
Two years of experience in a health‑care financial setting, or equivalency (one year of education can be substituted for two years of related work experience).
Preferred Qualifications
Previous experience with medical insurance and prior authorizations.
ICD/CPT coding experience.
Outpatient or radiology prior authorization experience.
Job Details
Requisition Number: PRN43511B
Full Time
Work Schedule: Monday – Friday
Department: 01455 – Dermatology Clinical Hpp
Location: Other
Pay Rate Range: $19.27 – $25.49 per hour
Close Date: 11/11/2025
To apply, visit https://utah.peopleadmin.com/postings/191600