Pre-Certification Authorization Coordinator

Virginia AG; Charlottesville (VA); On-site; USD 38,000 - 69,000; Full time

Benefits offered by this job

Medical, Dental, Vision

PTO & Disability

Health Savings Plan

Education support

Retirement savings

Job summary

UVA Health in Charlottesville, VA seeks a Pre-Certification/Pre-Authorization Specialist to obtain pre-certifications for inpatient admissions and pre-authorizations for outpatient tests, applying policies with independent judgment in a medical setting.

The role emphasizes accurate data entry into UVA software, effective communication, and adherence to procedures while supporting denial-rate goals and revenue protection for the health system.

Qualifications

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

Responsibilities

• Obtains pre-certifications and pre-authorizations for procedures with insurance carriers.
• Enters information into required computer systems accurately and timely using UVA software.
• Demonstrates effective communication, decision-making, and organizational skills.
• Adheres to policies and procedures.
• Other duties may be assigned.

Skills

Effective communication

Decision-making

Organization

Adherence to policies

Education

High School Diploma or equivalent

Associates degree preferred

Tools

UVA software systems

PC software

Job description

Obtains pre-certification for all inpatient admission and pre-authorization for all outpatient diagnostic tests and performs an administrative support function. This job requires the application and interpretation of policies and procedures and the use of independent judgment in a medical setting. The purpose is to achieve the goals and to meet the denial rates set by Patient Access the Medical Center and HSF to ensure minimum loss of revenue and maximum payment for services. The ability to maintain a working knowledge of carrier contracts/changes and departmental policies and procedures is required.

• Analyzes information required to complete pre-certifications and/or authorizations with insurance carriers service area contacts and workman’s compensation carriers.
• Demonstrates skill in the proficient use of PC and UVA software systems to ensure that all pre-certification/pre-authorization information is entered into required computer systems in an accurate and timely manner.
• Demonstrates the skills of effective communication decision-making and organization to ensure efficient job performance and job success.
• Demonstrates ability to adhere to policies and procedures.
• In addition to the above job responsibilities, other duties may be assigned.

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.