Job Details

Prior Authorization Rep I

Position Number: 6841930
Location: Salt Lake City, UT
Position Type: Health - Healthcare Administration

Prior Authorization Rep I

Job Summary

We are looking for an experienced Prior Authorization Representative to join our team. As the Prior Authorization Representative I, you will be responsible for ensuring accounts by performing insurance verification, obtaining benefit information, calculating patient estimates, and obtaining prior authorization before services are rendered. This position works with physicians, nurses, clinic managers and financial advocates to resolve issues that arise during the prior authorizations process. This position is not responsible for providing care to patients. Entry-level position within field. Requires basic skill set and proficiency.

Compensation & Benefits
The starting salary for this position is $21 to $25/hr, depending on experience. Members of UMB are eligible for a bonus based on department performance. All team members are eligible for the University's comprehensive benefit package that includes 90% employer-paid medical insurance, a generous 14.2% retirement contribution, reduced tuition, PTO and holiday pay, and more!

Employment is contingent on the successful completion of a background check and the adherence to departmental policies, including UMB's Telecommuting Agreement which requires a distraction-free and HIPAA compliant workplace, cameras on for all virtual calls/meetings, and the ability to work during office hours or assigned shift (M-F, approximately 8am to 5pm Mountain Time) regardless of what time zone you live in. Additionally, new hires are required to provide their own monitors (two) and reliable internet service.

Responsibilities
Essential Functions

Contact insurance companies for patient eligibility, benefits, network status and authorization. 35%
- Update patient registration with insurance information.
- Follow-up on delayed or denied authorization requests, escalate for resolution.
- Maintain familiarity with contracts, payer guidelines, and resources to determine appropriate coverage and eligibility.
- Resolve claims denials related to the prior authorization, as needed.
Review and summarize pre-authorization criteria for medical necessity to aid departments with procedure scheduling and/or financial advocate needs. 45%
- Create and maintain detailed documentation of authorization history.
Serve as a liaison between the payer and clinic schedulers/medical support staff. 20%
Complete other duties as assigned to support team and department.

This job description is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to the job.

Minimum Qualifications
Required
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
Previous experience with medical insurance and prior-authorizations.
ICD/CPT coding experience.
Outpatient or Radiology prior authorizations experience.

Preferences
An especially qualified candidate will also possess the following:

2 years' experience in a medical setting
Ability to communicate effectively with customers
Ability to accurately prepare and submit authorization forms

Applicants must demonstrate the potential ability to perform the essential functions of the job as outlined in the position description. Disclaimer
This job description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to the job.

Special Instructions
While UMB is a remote department and this role will be performed remotely, interested applicants should note the following:

This role is expected to work during UMB office hours which are Monday through Friday, 8am to 5pm Mountain Time.
The University of Utah is committed to providing jobs to individuals located in Utah, and sees remote roles like this as an opportunity to provide amazing employment opportunities to those living in remote areas of the state. As such, Utah-based applicants may be prioritized in the screening process.
At this time, the University of Utah is unable to employ individuals living in California, Colorado, New York, Oregon, or Washington.

Requisition Number: PRN43980B
Full Time or Part Time? Full Time
Work Schedule Summary: UMB Office Hours; M-F 8:00am to 5:00pm
Department: 00209 - Univ Medical Billing - Oper
Location: Other
Pay Rate Range: $21 to $25 per hour
Close Date: 3/9/2026
Open Until Filled:

To apply, visit https://utah.peopleadmin.com/postings/194628