Prior Authorization Specialist - Healthcare Access Champion

VSI; Reston (VA); On-site; USD 52,000 - 68,000; Full time

Benefits offered by this job

Full benefits

401k with company match

3 weeks paid time off

Job summary

VSI (formerly the Virginia Spine Institute), the leading multidisciplinary spinal healthcare practice in the Washington D.C. metropolitan area, is seeking an Insurance Authorization Specialist to join our team.

This full-time role is based in Reston and focuses on obtaining prior authorization for a range of procedures, therapies, and medications. The ideal candidate will have exceptional customer service skills, professional phone etiquette, and the ability to navigate insurance policies.

Qualifications

• Bachelor's degree in business or related field.
• 1-3 years of billing or authorization experience in the healthcare industry.
• Familiarity navigating the appeals process with insurances and external agencies.
• Solution oriented problem solver with strong organizational skills.
• Strong multitasking ability; detail oriented.
• Proficient with oral and written communication, articulate, professional and friendly.

Responsibilities

• Facilitate prior authorization for a variety of services (surgery, injections, medications, imaging) in a timely manner and secure final approval.
• Ensure accurate and complete medical documentation prior to submission.
• Coordinate with workers' compensation case managers to streamline authorizations.
• Track and monitor prior authorization status throughout the insurance approval process.
• Use knowledge of insurance plans and medical policies to complete prior authorization requirements.
• Coordinate with clinical staff to notify approvals/denials and facilitate appeals and peer-to-peer reviews.
• Verify insurance benefits.
• Work with the Director of Billing to identify trends in denials and improve the authorization process.
• Provide excellent customer service to patients regarding insurance authorization requirements.

Skills

Customer service

Phone etiquette

Organizational skills

Multitasking

Written and verbal communication

Billing/authorization experience

Appeals process familiarity

Education

Bachelor's degree in business or related field

Job description

VSI (formerly the Virginia Spine Institute), the leading multidisciplinary spinal healthcare practice in the Washington D.C. metropolitan area, is seeking an Insurance Authorization Specialist to join our team.

This full-time role is based in Reston and focuses on obtaining prior authorization for a range of procedures, therapies, and medications. The ideal candidate will have exceptional customer service skills, professional phone etiquette, and the ability to navigate insurance policies.