Medical Assistant – Prior Authorization Specialist

Sandy, Utah | $24–$28/hour

A growing specialty healthcare organization is seeking an experienced Medical Assistant with strong prior authorization experience to join its team in Sandy.

This role requires someone who has worked directly with specialty medications and complex insurance authorizations, including reviewing clinical requirements, step therapy, medication history, medical necessity, payer guidelines, denials, and appeals.

The ideal candidate understands both the clinical side of patient care and the insurance authorization process and is comfortable working closely with providers, clinical teams, and insurance companies to help patients receive needed treatment without unnecessary delays.

The organization offers a supportive, collaborative culture focused on putting people first, taking ownership, bringing passion to the work, and supporting one another.

What You’ll Do

• Manage approximately 30+ active prior authorizations
• Process complex medication prior authorizations
• Review clinical documentation, payer requirements, step therapy, and medical necessity criteria
• Verify medical and pharmacy benefits
• Determine in-network and out-of-network coverage
• Communicate with insurance companies regarding authorization requirements and case status
• Identify missing documentation and work with providers to obtain necessary clinical information
• Manage denials, appeals, and escalated authorization cases
• Accurately document case activity and follow-up
• Prioritize multiple authorizations and deadlines
• Research and resolve complex insurance and coverage issues
• Collaborate closely with providers, clinical staff, and internal teams
• Communicate with bilingual spanish patients, if bilingual spanish skills are present

Required Qualifications

• Medical Assistant certification or formal MA training – preferred
• 2–3+ years of Medical Assistant experience
• Direct experience processing prior authorizations for specialty medications – REQUIRED
• Experience working with complex medication approvals, including clinical criteria, step therapy, and insurance requirements
• Experience handling denials and appeals
• Strong knowledge of insurance benefits and payer processes
• Ability to understand and interpret clinical documentation
• Strong organization, documentation, and follow-through
• Excellent communication and problem-solving skills
• Ability to manage a high-volume caseload and multiple deadlines

Preferred Experience

Bilingual Spanish valued but not necessary!

Experience working in specialties such as:

Rheumatology | Gastroenterology | Dermatology | Neurology | Immunology

Experience with Salesforce, WeInfuse, AdvancedMD, EMRs, CRMs, payer portals, or similar authorization systems is helpful.

Culture

This is a people-focused organization that values team members who:

• Put patients and people first
• Bring passion and energy to their work
• Take ownership and look for solutions
• Work collaboratively
• Appreciate and support the people around them

If you are an experienced Medical Assistant who has personally handled complex medication prior authorizations and enjoys solving insurance challenges that directly impact patient care, this could be an excellent next step.

Pay: $24.00–$28.00 per hour

Location: Sandy, Utah

Seniority Level

Associate

Industry

Hospitals and Health Care

Employment Type

Full-time

Job Functions

Prior Authorizations • Intake • Medical Assisting • Revenue Cycle • Patient Access

Skills

Medical Assistant • Prior Authorizations • Insurance Verification • Referrals • Intake • Revenue Cycle Management • Patient Access • AdvancedMD • EMR • HIPAA

Apex Recruiting Professionals is specific to Healthcare Recruitment in RCM, Medical Office Support Staff, MA’s, RN’s, Administrative