Senior Insurance Authorization Specialist (Hybrid)

Inova Health System; Virginia; Híbrido; USD 70 000 - 100 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Health coverage

Retirement match

Education assistance

Mental health support

Resumo da oferta

Inova Health System in Virginia seeks an experienced Insurance Authorization Specialist Senior to join as a hybrid, full-time role with daytime hours. The position focuses on complex authorizations, payer policy interpretation, and collaboration with clinical teams to ensure medical necessity and accurate pre-service clearance.

A background in healthcare revenue cycle is required. Preferred bilingual Spanish, experience with Epic scheduling, and the ability to manage high-volume calls and

Qualificações

• 4 years of healthcare revenue cycle, patient access, authorizations, preservice financial clearance, or related healthcare operations.

Responsabilidades

• Acts as SME for complex authorization and preservice financial clearance workflows across multiple specialty services.
• Manages high-complexity authorization cases including advanced procedural services and high-acuity programs.
• Interprets payer policies to ensure compliance and prevent denials; handles escalations and non-standard pathways.
• Coordinates peer-to-peer reviews, payer escalations, and complex authorization resolutions when clinical review is required.
• Collaborates with physicians and clinical teams to ensure documentation and medical necessity before service.

Conhecimentos

Healthcare revenue cycle

Payer policy interpretation

Bilingual - Spanish (preferred)

Attention to detail

Formação académica

High school diploma or GED

Ferramentas

Epic Scheduling (EPIC)

Descrição da oferta de emprego

Inova Health System in Virginia seeks an experienced Insurance Authorization Specialist Senior to join as a hybrid, full-time role with daytime hours. The position focuses on complex authorizations, payer policy interpretation, and collaboration with clinical teams to ensure medical necessity and accurate pre-service clearance.

A background in healthcare revenue cycle is required. Preferred bilingual Spanish, experience with Epic scheduling, and the ability to manage high-volume calls and