Prior Authorization Specialist – Healthcare Access

Horizon Health Corporation; Washington (District of Columbia); On-site; USD 60,000 - 75,000; Full time

Benefits offered by this job

Competitive Compensation

Career development opportunities

Excellent Medical, Dental, Vision, and

Generous Paid Time Off

401(K) with company match and stock

Tuition Reimbursement

SoFi Student Loan Refinancing Program

Employee Assistance Program

Job summary

George Washington University Hospital is seeking a Pre-Authorization Representative to identify payer requirements and obtain prior authorizations for scheduled and add-on services. The role requires documenting in CERNER/EPIC and communicating with ordering providers on outcomes.

Ideal candidates will have an Associate degree in business or related major and five years of health-care facility experience; CHAA certification is preferred.

Qualifications

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

Responsibilities

• Identify prior authorization requirements by insurance/payer and determine coverage.
• Obtain prior authorizations for scheduled and add-on services.
• Document information in CERNER and EPIC and update providers on approval/denial status.
• Facilitate peer-to-peer reviews to prevent denials and improve physician satisfaction.

Education

Associate degree in business or related major

Job description

George Washington University Hospital is seeking a Pre-Authorization Representative to identify payer requirements and obtain prior authorizations for scheduled and add-on services. The role requires documenting in CERNER/EPIC and communicating with ordering providers on outcomes.

Ideal candidates will have an Associate degree in business or related major and five years of health-care facility experience; CHAA certification is preferred.