Insurance Authorization Specialist
Inova Health System
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- Location
- Virginia, United States
- Work style
- Hybrid
- Job type
- Full time
- Posted
- Oct 13
- 7 days ago
Career path
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About the company
Inova Health System
Hospital & health care · 10,001+ employees
Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation.
What you'll do
- Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program.
- Retirement: Inova matches the first 5% of eligible contributions – starting on your first day.
- Tuition and Student Loan Assistance: offering up to $5,250 per year in education assistance and up to $10,000 for student loans.
- Mental Health Support: offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost.
- Work/Life Balance: offering paid time off, paid parental leave, flexible work schedules, and remote and hybrid career opportunities
- Independently manages authorization and preservice financial clearance activities for moderate to complex specialty services, including surgeries, procedures, rehabilitation services, neurology services, recurring department services, and specialty clinic treatments.
- Performs detailed review of payer medical policies, insurance coverage requirements, and medical necessity criteria to ensure appropriate authorization submission and denial prevention.
- Coordinates closely with clinical schedulers, clinics, and operational teams to ensure service-line–specific authorization requirements and documentation standards are met.
- Manages authorization requests through payer portals and electronic workflows while proactively monitoring status and performing follow-up with insurance payers to facilitate timely approvals.
- Maintains a strong working knowledge of payer policies, insurance plans, and specialty service-line authorization requirements.
- Collaborates with operational teams to support workflow improvements related to authorization processing, preservice financial clearance, and patient access operations.
- May perform additional duties as assigned.
- Experience - 2 years of healthcare revenue cycle, patient access, authorizations, preservice financial clearance, or related healthcare operations
- Education - High school or GED
- Strong background in healthcare authorization, patient access, revenue cycle, or preservice financial clearance.
- Experience working with complex specialty services and payer authorization requirements.
- Knowledge of insurance eligibility, benefits verification, medical necessity guidelines, and financial counseling.
- Strong analytical, problem-solving, and customer service skills.
- Ability to work independently, manage multiple priorities, and thrive in a fast-paced healthcare environment.
What you need
- Requires 2 years of healthcare revenue cycle, patient access, authorizations, preservice financial clearance, or related healthcare operations experience, and a high school diploma or GED.
- Education: a high school diploma
Key skills
healthcare revenue cyclepatient accessauthorizationspreservice financial clearanceinsurance eligibilitybenefits verificationmedical necessity guidelinesfinancial counselinganalyticalproblem-solvingcustomer service
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Perks
- medical, dental and vision coverage
- wellness program
- Retirement
- Tuition and Student Loan Assistance
- Mental Health Support
- paid time off
- paid parental leave
- flexible work schedules
See full description on company page, apply now
Read the full posting here
Inova is looking for a dedicated Insurance Authorization Specialist to join the team. This role will be Full-Time Shift = 9:30am - 6:00pm M-F/ Hybrid following initial 90-days on-site training.
Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation.
Featured Benefits:
Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program.
Retirement: Inova matches the first 5% of eligible contributions – starting on your first day.
Tuition and Student Loan Assistance: offering up to $5,250 per year in education assistance and up to $10,000 for student loans.
Mental Health Support: offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost.
Work/Life Balance: offering paid time off, paid parental leave, flexible work schedules, and remote and hybrid career opportunities
Job Responsibilities:
Independently manages authorization and preservice financial clearance activities for moderate to complex specialty services, including surgeries, procedures, rehabilitation services, neurology services, recurring department services, and specialty clinic treatments.
Performs detailed review of payer medical policies, insurance coverage requirements, and medical necessity criteria to ensure appropriate authorization submission and denial prevention.
Coordinates closely with clinical schedulers, clinics, and operational teams to ensure service-line–specific authorization requirements and documentation standards are met.
Manages authorization requests through payer portals and electronic workflows while proactively monitoring status and performing follow-up with insurance payers to facilitate timely approvals.
Maintains a strong working knowledge of payer policies, insurance plans, and specialty service-line authorization requirements.
Collaborates with operational teams to support workflow improvements related to authorization processing, preservice financial clearance, and patient access operations.
May perform additional duties as assigned.
Additional Requirements:
Experience - 2 years of healthcare revenue cycle, patient access, authorizations, preservice financial clearance, or related healthcare operations
Education - High school or GED
Preferred Candidate Profile:
Strong background in healthcare authorization, patient access, revenue cycle, or preservice financial clearance.
Experience working with complex specialty services and payer authorization requirements.
Knowledge of insurance eligibility, benefits verification, medical necessity guidelines, and financial counseling.
Strong analytical, problem-solving, and customer service skills.
Ability to work independently, manage multiple priorities, and thrive in a fast-paced healthcare environment.