Insurance Authorization Lead

Inova Health; Fairfax (VA); Hybrid; USD 70,000 - 90,000; Full time

Benefits offered by this job

Health coverage

Retirement match

Education assistance

Student loan help

Mental health support

Paid time off

Job summary

Inova Fairfax Hospital is seeking an Insurance Authorization Lead. This role is hybrid, with a schedule Monday–Friday 9:00 AM–5:30 PM and occasional rotating weekend shifts (Saturday).

The position leads the authorization team, ensuring efficient workflows and compliance with payor guidelines. The ideal candidate has extensive experience in healthcare revenue cycle, preservice clearance, and estimates, with a focus on performance metrics and quality audits.

Qualifications

• Education: High School or GED.
• Experience: Five (5) years of healthcare revenue cycle, patient access, authorizations, preservice financial clearance, or related healthcare operations.

Responsibilities

• Serves as the primary team lead for workflows, payor requirements, authorizations, and financial clearance.
• Oversees productivity, queues, turnaround times, and performance metrics for authorization timeliness and denial prevention.
• Performs complex authorization activities across multiple service lines including high-acuity and specialty services.
• Ensures preservice workflows are complete and accurate, including financial clearance and patient responsibility estimates.
• Conducts routine quality audits of authorization and estimate processes for accuracy and compliance.
• Analyzes denial trends and workflow gaps to identify root causes and drive improvements.
• Mentors and onboards staff; liaises between frontline staff and leadership; provides coverage as needed.

Education

High School or GED

Job description

Inova Fairfax Hospital is looking for a dedicated Insurance Authorization Lead to join the team. This role will be Hybrid; Monday-Friday, 9:00 AM – 5:30 PM with an occasional rotating weekend shift (Saturday).

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: offeringup 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: offeringpaid time off, paid parental leave, flexible work schedules, and remote and hybrid career opportunities.

Insurance Authorization Lead Job Responsibilities

• Serves as the primary team lead and operational resource, providing day‑to‑day guidance on workflows, payor requirements, authorization processes, preservice financial clearance, and estimate workflows.
• Oversees team productivity, work queues, turnaround times, and performance metrics—including authorization timeliness, clearance completion, estimate accuracy, and denial prevention—to ensure service level and operational standards are met.
• Performs and supports complex authorization activities across multiple service lines, including high‑acuity and specialty services requiring advanced medical policy interpretation and cross‑functional coordination.
• Ensures preservice workflows are completed accurately and timely, including authorizations, medical necessity validation, financial clearance, and patient responsibility estimates in alignment with financial transparency standards.
• Conducts routine quality audits of authorization, preservice, and estimate processes to ensure accuracy, compliance with payor guidelines, and adherence to organizational policies.
• Analyzes workflow outcomes, denial trends, and operational gaps to identify root causes and recommend process improvements, automation opportunities, and workflow optimization initiatives.
• Provides mentoring, coaching, and onboarding support to strengthen team knowledge and performance; serves as a liaison between frontline staff and leadership while providing operational coverage as needed to maintain workflow continuity.
• Oversees and assists team members in assigned functional area, which may include but not limited to, ensuring team is meeting key-deliverables and quality standards, addressing and resolving challenges, managing and tracking performance, and assisting in time management and scheduling; escalates issues to senior leaders as needed.
• May perform additional duties as assigned.

Minimum Qualifications

• Education: High School or GED
• Experience: Five (5) years of healthcare revenue cycle, patient access, authorizations, preservice financial clearance, or related healthcare operations

Preferred Qualifications

• Experience: Authorization experience on payer portals; Oncology experience is a plus
• Other: Comfortability in training other staff members & working on a team

About Us

We are Inova, Northern Virginia’s leading nonprofit healthcare provider. Every day, our 26,000+ team members provide world-class healthcare to the communities we serve. Our people are the reason we're a national leader in healthcare safety, quality and patient experience. And from best‑in‑class facilities to professional development opportunities, we support them at every step. At Inova, we're constantly striving to be ever better — to shape a more compassionate future for healthcare.

Inova Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, pregnancy (including childbirth, pregnancy‑related conditions and lactation), race, religion, sex, sexual orientation, veteran status, genetic information, or any other characteristics protected by law.