Pre-Certification Authorization Coordinator

Commonwealth of VA Careers; Charlottesville (VA); On-site; USD 25,000 - 46,000; Full time

Benefits offered by this job

Medical, Dental, Vision

PTO (Paid Time Off)

Disability Insurance

Retirement Savings

HSA / FSA

Education support

Job summary

UVA Health in Charlottesville seeks a detail-oriented professional to join the Pre-Arrival Unit, ensuring timely financial clearances by verifying benefits, obtaining authorizations, and coordinating with clinical teams. You will navigate payer requirements, manage multiple systems, and own complex cases to keep patient care on track.

The role emphasizes analysis, collaboration across patients, providers, payers, and operations, and engagement with infusion and specialty-service authorizations.

Qualifications

• Education: High School Diploma or equivalent required; Associates degree preferred.
• Experience: 3+ years in healthcare financial clearance or related field.
• Licensure: None.

Responsibilities

• Verify benefits and file orders to support financial clearance.
• Review documentation to determine authorization requirements.
• Submit and track authorizations and predeterminations with payer portals and other channels.
• Manage Epic work queues and prioritize cases by service dates and payer needs.
• Collaborate with patients, providers, payers, and operations to resolve issues.
• Support infusion and specialty-service authorizations and treatment plan reviews.
• Escalate denials and unresolved cases within required timeframes to prevent delays.

Skills

Analytical problem-solving

Multi-system coordination

Ownership of complex cases

Stakeholder communication

Education

High School Diploma or equivalent

Associates degree preferred

Tools

Epic

Job description

The Role

As a member of the Pre-Arrival Unit, you will help financially clear scheduled services before patient arrival by verifying benefits, obtaining prior authorizations, documenting payer decisions, and coordinating with clinical and operational teams. Your ability to manage complex cases, interpret payer requirements, and proactively resolve barriers will directly contribute to patient access and operational success.

A typical day may include:

• Managing Epic work queues and prioritizing cases based on service dates, payer requirements, and financial risk factors.
• Verifying insurance coverage, benefits, and filing order to support accurate financial clearance.
• Reviewing provider, facility, diagnosis, procedure, drug, and clinical documentation to determine authorization requirements.
• Submitting, tracking, and documenting authorizations and predeterminations through payer portals, phone, and other communication channels.
• Collaborating with patients, providers, pharmacies, payers, and operational partners to resolve issues and maintain treatment timelines.
• Supporting infusion and specialty-service authorizations , including specialty medications and treatment plan reviews.
• Escalating denials and unresolved cases within required timeframes to help prevent delays in care and reimbursement.

This role is ideal for professionals who enjoy analytical problem-solving, working in a fast-paced environment, managing multiple systems simultaneously, and taking ownership of complex cases through resolution.

Why UVA Health

At UVA Health, revenue cycle professionals are recognized as essential contributors to patient care. This position offers the opportunity to combine technical expertise with meaningful healthcare impact while supporting one of the nation's leading academic health systems.

Why professionals choose UVA Health:

• Direct impact on patient access and timely treatment , ensuring patients can receive needed services without unnecessary delays.
• Exposure to complex and specialized authorizations , including infusion, specialty medications, procedural, surgical, and diagnostic services.
• Collaboration across clinical, pharmacy, payer, and operational teams , providing broad healthcare operations experience.
• Advanced technology and workflow tools , including Epic and evolving electronic authorization capabilities.
• Continuous professional development , structured training, process improvement opportunities, and ongoing learning within Revenue Cycle Operations.
• A collaborative, patient-centered culture built on communication, accountability, partnership, continuous learning, and data-driven improvement.

Why People Love Living in Charlottesville

Charlottesville offers an exceptional quality of life with the perfect balance of professional opportunity and personal fulfillment. Nestled near the Blue Ridge Mountains, the area provides access to hiking, cycling, wineries, vibrant arts and music, outstanding restaurants, and a welcoming community atmosphere. Residents enjoy the charm of a historic college town, excellent schools, and convenient access to major metropolitan areas while benefiting from a slower pace and abundant outdoor recreation. For healthcare professionals and families alike, Charlottesville is a place where career growth and lifestyle can thrive together.

MINIMUM REQUIREMENTS:

• Education: High School Diploma or equivalent required; Associates degree preferred.
• Experience: 3+ years relevant experience required.
• Licensure: None

PHYSICAL DEMANDS

Job requires sitting for prolonged periods, attention to detail, must be able to hear, speak, read and write legibly.

The pay range for this role is $18.37 - $33.28 hourly. Individual compensation will be determined by the selected candidate's qualifications, previous work experience, and/or education.

Benefits

• Comprehensive Benefits Package: Medical, Dental, and Vision Insurance
• Paid Time Off, Long-term and Short-term Disability, Retirement Savings
• Health Saving Plans, and Flexible Spending Accounts
• Certification and education support
• Generous Paid Time Off

UVA Health is a world-class Magnet Recognized academic medical center and health system with a level 1 trauma center. 2023-2024 U.S. News & World Report “Best Hospitals” guide rates UVA Health University Medical Center as “High Performing” in 5 adult specialties and 14 conditions/procedures. We are one of 70 National Cancer Institute designated cancer centers. UVA Health Children’s is named by 2023-2024 U.S. News & World Report as the best children's hospital in Virginia with 9 specialties ranked among the best in the nation. Our footprint also encompasses 3 community hospitals and an integrated network of primary and specialty care clinics throughout Charlottesville, Culpeper, Northern Virginia, and beyond.

The University of Virginia is an equal opportunity employer. Learn more about UVA’s commitment to non-discrimination and equal opportunity employment .