Pre-Certification & Authorization Specialist

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

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.