Insurance Authorization Specialist - Pre Service

Inova Health System; Virginia (MN); Hybrid; USD 48,000 - 64,000; Full time

Benefits offered by this job

Medical, dental & vision

Retirement match

Education assistance

Mental health support

Remote and hybrid opportunities

Job summary

Inova Health System seeks an Insurance Authorization Specialist to join our Revenue Cycle team. This full-time, hybrid role begins with 90 days on-site training, then hybrid work arrangements.

You will independently manage authorizations for complex services, review payer policies, coordinate with clinics, and ensure timely approvals through payer portals. A background in healthcare revenue cycle and strong problem-solving skills are essential.

Qualifications

• 2 years of healthcare revenue cycle, patient access, authorizations, or related operations.
• High school diploma or GED.

Responsibilities

• Independently manages authorization and preservice financial clearance activities for moderate to complex specialty services.
• Performs detailed review of payer 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.

Skills

Healthcare revenue cycle

Patient access

Authorizations

Payer policies

Customer service

Detail-oriented

Education

High school 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.