Insurance Authorization Specialist

VSI; Reston (VA); On-site; USD 52,000 - 68,000; Full time

Benefits offered by this job

Full benefits

401k with company match

3 weeks paid time off

Job summary

VSI (formerly the Virginia Spine Institute), the leading multidisciplinary spinal healthcare practice in the Washington D.C. metropolitan area, is seeking an Insurance Authorization Specialist to join our team.

This full-time role is based in Reston and focuses on obtaining prior authorization for a range of procedures, therapies, and medications. The ideal candidate will have exceptional customer service skills, professional phone etiquette, and the ability to navigate insurance policies.

Qualifications

• Bachelor's degree in business or related field.
• 1-3 years of billing or authorization experience in the healthcare industry.
• Familiarity navigating the appeals process with insurances and external agencies.
• Solution oriented problem solver with strong organizational skills.
• Strong multitasking ability; detail oriented.
• Proficient with oral and written communication, articulate, professional and friendly.

Responsibilities

• Facilitate prior authorization for a variety of services (surgery, injections, medications, imaging) in a timely manner and secure final approval.
• Ensure accurate and complete medical documentation prior to submission.
• Coordinate with workers' compensation case managers to streamline authorizations.
• Track and monitor prior authorization status throughout the insurance approval process.
• Use knowledge of insurance plans and medical policies to complete prior authorization requirements.
• Coordinate with clinical staff to notify approvals/denials and facilitate appeals and peer-to-peer reviews.
• Verify insurance benefits.
• Work with the Director of Billing to identify trends in denials and improve the authorization process.
• Provide excellent customer service to patients regarding insurance authorization requirements.

Skills

Customer service

Phone etiquette

Organizational skills

Multitasking

Written and verbal communication

Billing/authorization experience

Appeals process familiarity

Education

Bachelor's degree in business or related field

Job description

VSI (formerly the Virginia Spine Institute), the leading multidisciplinary spinal healthcare practice in the Washington D.C. metropolitan area, is seeking an Insurance Authorization Specialist to join our team. This role is responsible for obtaining prior authorization for various medical procedures, services, and medications.

This is a full-time position working out of our Reston office. The position offers competitive pay, full benefits, 401k plan with a Company match, and three weeks of paid time off. The ideal candidate will have exceptional customer service skills and phone etiquette.

Duties & Responsibilities

• Responsible for facilitating prior authorization for a variety of services (surgery, injections, medications, imaging, etc.) in a timely manner and working efficiently to facilitate a final approval.
• Ensures all pertinent medical documentation is accurate and complete prior to authorization submission.
• Coordinates with workers' compensation case managers to streamline authorizations for care
• Tracks and monitors prior authorization status throughout the insurance approval process.
• Utilizes a thorough working knowledge of insurance plans and medical policies to complete prior authorization requirements.
• Coordinates with clinical staff during the prior authorization process to include notification of prior authorization approvals and denials in addition to facilitating appeals and peer-to-peer reviews with the payer.
• Responsible for insurance benefits verification.
• Works directly with the Director of Billing to identify trends in denials and opportunities for improvement in the authorization process.
• Provides superior customer service when communicating with patients to resolve all inquiries regarding insurance authorization requirements.
  

Skills/Qualifications/Behaviors

• Bachelors degree in business or related field
• 1-3 years of billing or authorization experience in the healthcare industry
• Familiarity in navigating the appeals process with insurances and external agencies
• Solution oriented problem solver, helpful and strong organizational skills
• Strong multitasking ability; detail oriented
• Proficient with oral and written communication, articulate, professional and friendly