Pre-Authorization Specialist: Healthcare Access & Denials Expert

Henderson Hospital; Washington (District of Columbia); On-site; USD 70,000 - 95,000; Full time

Benefits offered by this job

Competitive Compensation

Excellent Medical, Dental, Vision

401(K) with company match

Tuition Reimbursement

Employee Assistance Program

Job summary

George Washington University Hospital in Washington, DC seeks a Pre-Authorization Specialist to identify and obtain prior authorizations for scheduled and add-on services. The role requires determining coverage, documenting in CERNER and EPIC, and communicating outcomes to the ordering provider.

Ideal candidates have five years in healthcare settings and an Associate degree in business or related field, with CHAA certification preferred.

Qualifications

• Associate degree in business or related major is required.
• Five (5) years' experience in a health care facility or equivalent position required.
• CHAA certification preferred.

Responsibilities

• Identify prior authorization requirements by insurance/payer and obtain prior authorizations for scheduled and add-on services.
• Determine if services are a covered benefit and document information in CERNER and EPIC.
• Communicate with the ordering Provider’s office about approvals or denials and facilitate peer-to-peer reviews when needed.

Skills

Attention to detail

Communication skills

Problem solving

Education

Associate degree in business or related major

Tools

CERNER

EPIC

Job description

George Washington University Hospital in Washington, DC seeks a Pre-Authorization Specialist to identify and obtain prior authorizations for scheduled and add-on services. The role requires determining coverage, documenting in CERNER and EPIC, and communicating outcomes to the ordering provider.

Ideal candidates have five years in healthcare settings and an Associate degree in business or related field, with CHAA certification preferred.