Senior Insurance Authorization Specialist — Hybrid

Inova Health; Virginia (MN); Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

401(k) with 5% match

Education assistance up to $5,250/year

Mental health support and coaching

Job summary

Inova Health in Northern Virginia seeks an Insurance Authorization Specialist Senior to join our team on a full-time day shift with a hybrid work arrangement. You will handle complex pre‑service authorizations across multiple service lines, ensuring medical necessity and payer compliance.

The role requires 4 years in healthcare revenue cycle, strong communication, and bilingual Spanish is a plus. Epic scheduling experience is preferred, with a patient‑focused approach and attention to detail.

Qualifications

• High school diploma or GED required.
• 4 years of healthcare revenue cycle or related experience.
• Bilingual Spanish preferred or helpful.

Responsibilities

• Serve as SME for complex authorization and preservice workflows across multiple service lines.
• Manage high-complexity authorization cases including advanced procedures and specialty programs.
• Interpret payer policies to ensure compliance and prevent denials; handle escalations.
• Coordinate peer-to-peer reviews, payer escalations, and complex authorization resolution.
• Collaborate with physicians, clinical teams, schedulers, and leadership to ensure medical necessity.
• Support denial prevention and revenue risk mitigation; review coverage and clearance requirements.
• Review complex estimate scenarios and identify opportunities to improve accuracy.
• Maintain expert knowledge of payer requirements and service-line policies.

Skills

Bilingual Spanish

Multitasking

Attention to detail

HIPAA compliance

Strong communication

Education

High school diploma or GED

Tools

Epic scheduling

Job description

Inova Health in Northern Virginia seeks an Insurance Authorization Specialist Senior to join our team on a full-time day shift with a hybrid work arrangement. You will handle complex pre‑service authorizations across multiple service lines, ensuring medical necessity and payer compliance.

The role requires 4 years in healthcare revenue cycle, strong communication, and bilingual Spanish is a plus. Epic scheduling experience is preferred, with a patient‑focused approach and attention to detail.