PRE-AUTHORIZATION REPRESENTATIVE

Universal Health Services; Washington (District of Columbia); On-site; USD 60,000 - 85,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision plan

401(k) with company match

Paid time off

Tuition reimbursement

SoFi student loan refinancing program

Employee assistance program

Career development opportunities

Job summary

The Pre-Authorization Specialist at George Washington University Hospital identifies prior authorization requirements and coordinates with insurers to obtain authorizations for scheduled and add-on services. Documentation occurs in CERNER and EPIC, with clear communication to the ordering provider about approvals or denials, and peer-to-peer reviews as needed.

Working at a leading academic medical center in downtown Washington, DC, this role supports optimal patient access and payer relations,

Qualifications

• Five (5) years' experience in a health care facility or equivalent position performing same or similar job duties required.
• CHAA - (Certified Healthcare Access Associate) certification preferred.

Responsibilities

• Identify prior authorization requirements by insurer/payer for scheduled and add-on services.
• Obtain pre-authorization and document information in CERNER and EPIC.
• Communicate outcomes to ordering providers and facilitate peer-to-peer reviews to prevent denials and improve physician satisfaction.

Skills

Communication

Attention to detail

Teamwork

Education

Associate degree in business or related major

Tools

CERNER

EPIC

Job description

Responsibilities

Join Our Exceptional Team at George Washington University Hospital

Since opening its doors in 2002, George Washington University Hospital has been at the forefront of medical innovation, providing cutting-edge care in a state-of-the-art facility. As a 395-bed tertiary care, academic medical center located in the heart of downtown Washington, DC, our hospital is renowned for its Level I Trauma Center and Level III NICU. We offer unparalleled expertise in cardiac, cancer, neurosciences, women’s health, and advanced surgical procedures, including robotic and minimally invasive techniques. Operated by Universal Health Services, Inc. (UHS), one of the nation’s leading healthcare providers, we are committed to excellence in patient care and organizational growth.

POSTION SUMMARY

The Pre-Authorization Specialist is responsible for identifying prior authorization requirements by insurance/payer, processes, and obtains prior authorizations for scheduled and add-on services. Determines if services are a covered benefit, obtains pre-authorization, and documents information in CERNER and EPIC. Communicates with the ordering Provider’s office if services were approved or denied and facilitates peer-to-peer reviews when needed to prevent denials and improve Physician satisfaction.

Benefit Highlights

• Challenging and rewarding work environment
• Competitive Compensation
• Career development opportunities across UHS and our 300+ locations!
• Excellent Medical, Dental, Vision, and Prescription Drug Plan
• Generous Paid Time Off
• 401(K) with company match and discounted stock plan
• Tuition Reimbursement
• SoFi Student Loan Refinancing Program
• Employee Assistance Program
• Career development opportunities within UHS and its Subsidiaries
• More information is available on our Benefits Guest Website: benefits.uhsguest.com

About Universal Health Services

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $15.8 billion in 2024. UHS was again recognized as one of the World’s Most Admired Companies by Fortune; listed in Forbes ranking of America’s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 99,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network, and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

Qualifications

Education Requirements:

• Associate degree in business or related major required

Experience:

• Five (5) years' experience in a health care facility or equivalent position performing same or similar job duties required.

License / Certification:

CHAA - (Certified Healthcare Access Associate) certification preferred.

EEO Statement:

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.