Insurance Authorization Specialist - Pre Service

Inova Health System; Falls Church (VA); Hybrid; USD 42,000 - 62,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Wellness program

Retirement matching

Education assistance

Student loan assistance

Mental health support

Paid time off

Parental leave

Flexible schedules

Remote/hybrid opportunities

Job summary

Inova Health System is seeking an Insurance Authorization Specialist to join our team. This full-time role supports preservice financial clearance for a range of services and coordinates with clinics, schedulers, and payers to obtain timely authorizations.

The ideal candidate has at least 2 years in healthcare revenue cycle or patient access, a High school diploma or GED, and strong analytical and customer service skills to thrive in a fast-paced environment.

Qualifications

• 2 years of healthcare revenue cycle, patient access, authorizations, preservice financial clearance, or related healthcare operations.
• High school diploma or GED.
• Experience with payer policies and medical necessity guidelines is preferred.

Responsibilities

• Manages authorization and preservice financial clearance for moderate to complex services.
• Reviews payer policies and medical necessity to ensure proper submission and deny prevention.
• Coordinates with schedulers, clinics, and operations to meet authorization requirements.
• Handles authorization requests via payer portals and tracks status for timely approvals.
• Maintains knowledge of payer policies and service-line requirements.
• Collaborates on workflow improvements for authorization processing and patient access.
• Performs additional duties as assigned.

Skills

Healthcare revenue cycle

Customer service

Analytical thinking

Education

High school diploma or GED

Job description

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.