Orthopedics Patient Access & Authorization Specialist

VCU Health; Colonial Heights (VA); On-site; USD 42,000 - 64,000; Full time

Job summary

VCU Health is seeking a qualified healthcare administrative professional to verify insurance coverage across plans, obtain referrals and authorizations, and document interactions in patient accounts. The role requires familiarity with billing systems, EMR/EHR platforms, and medical terminology.

The candidate will prepare cost estimates, explain payment expectations, and support chart preparation before visits, ensuring timely documentation and no-shows/cancellations are properly recorded.

Qualifications

• Experience using computers, Microsoft Office applications and web-based platforms.
• Experience with medical insurance, HMO, managed care and electronic medical billing/order entry/registration systems, and appointment scheduling.
• Previous healthcare setting experience and knowledge of medical terminology.
• Self-directed in completing routine activities with minimal supervision.

Responsibilities

• Verify insurance coverage and understand requirements for HMO, managed care, government and private plans.
• Secure referrals/authorizations and link them in the referral module.
• Obtain needed referrals/authorizations before scheduled procedures, tests, injections and surgeries.
• Communicate plan-specific referral/authorization requirements to patients and providers.
• Provide pre-payment guidance for self-pay patients and offer financial assistance.
• Prepare cost estimates and document interactions in the patient account.
• Maintain organized medical record keeping and assist in chart preparation before visits.
• Document no-shows or cancellations before the end of the appointment day.

Skills

Computers

Microsoft Office

Web-based platforms

Education

High School Diploma or equivalent

Associates or Bachelor's Degree in Accounting, Finance, Business Administration, Healthcare Administration or related field

Tools

EMR/EHR systems

Billing systems

Job description

VCU Health is seeking a qualified healthcare administrative professional to verify insurance coverage across plans, obtain referrals and authorizations, and document interactions in patient accounts. The role requires familiarity with billing systems, EMR/EHR platforms, and medical terminology.

The candidate will prepare cost estimates, explain payment expectations, and support chart preparation before visits, ensuring timely documentation and no-shows/cancellations are properly recorded.