Medical Prior Authorization Specialist — Patient-Focused

VSI | Spine Solutions; Reston (VA); On-site; USD 52,000 - 76,000; Full time

Benefits offered by this job

Full benefits

401k with company match

3 weeks paid time off

Job summary

VSI | Spine Solutions in Reston is seeking an Insurance Authorization Specialist to join our team. This full-time role focuses on obtaining prior authorizations for procedures, medications, and imaging, ensuring accurate documentation and timely submissions.

The ideal candidate brings 1–3 years of healthcare billing or authorization experience, strong customer service, excellent phone etiquette, and superb attention to detail. Competitive benefits and 401k are included.

Qualifications

• Bachelor's degree in business or a 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 and attention to detail.
• Proficient oral and written communication skills—articulate, professional, and friendly.

Responsibilities

• Facilitate prior authorization for a variety of services (surgery, injections, medications, imaging, etc.) in a timely manner and work efficiently to secure final approval.
• Ensure all pertinent medical documentation is accurate and complete prior to authorization submission.
• Coordinate with workers' compensation case managers to streamline authorizations for care.
• Track and monitor prior authorization status throughout the insurance approval process.
• Utilize a thorough working knowledge of insurance plans and medical policies to complete prior authorization requirements.
• Coordinate with clinical staff during the prior authorization process to include notification of approvals and denials, and facilitate appeals and peer‑to‑peer reviews with the payer.
• Verify insurance benefits.
• Work directly with the Director of Billing to identify trends in denials and opportunities for improvement in the authorization process.
• Provide superior customer service when communicating with patients to resolve all inquiries regarding insurance authorization requirements.

Skills

Customer service

Phone etiquette

Communication skills

Multitasking

Attention to detail

Problem solving

Education

Bachelor's degree in business or related field

Job description

VSI | Spine Solutions in Reston is seeking an Insurance Authorization Specialist to join our team. This full-time role focuses on obtaining prior authorizations for procedures, medications, and imaging, ensuring accurate documentation and timely submissions.

The ideal candidate brings 1–3 years of healthcare billing or authorization experience, strong customer service, excellent phone etiquette, and superb attention to detail. Competitive benefits and 401k are included.