Senior Insurance Authorization Specialist – Hybrid Role

Inova Health System; Fairfax (VA); Hybrid; USD 85,000 - 110,000; Full time

Benefits offered by this job

Medical, dental & vision

Retirement match 5%

Education assistance

Student loan assistance

Mental health program

Job summary

Inova Health System in Virginia is seeking an Insurance Authorization Specialist Senior for a full-time, day-shift role with a hybrid schedule. The position collaborates with physicians and billing staff to manage complex pre-service authorizations and ensure timely patient access.

The ideal candidate will have at least four years in healthcare revenue cycle, payer policy experience, and Epic scheduling proficiency. Bilingual Spanish is a plus, and HIPAA compliance is essential.

Qualifications

• Must have at least four years in healthcare revenue cycle, patient access, authorizations, or related operations.
• High school diploma or GED required.
• Experience with payer policies and pre-service financial clearance is preferred.

Responsibilities

• Serves as expert for complex authorization and preservice workflows across multiple service lines.
• Manages high-complexity authorization cases including advanced procedures and high-acuity programs.
• Interprets payer policies to avoid denials and handles escalations when needed.
• Coordinates peer-to-peer reviews and payer escalations for complex cases.
• Collaborates with physicians and clinical teams to ensure documentation and medical necessity is met.
• Supports denial prevention and reviews insurance coverage and financial clearance requirements.
• Reviews complex estimate scenarios and improves accuracy and automation.
• Maintains expert knowledge of payer requirements and specialty service-line policies.

Skills

Spanish bilingual

Customer service

Attention to detail

HIPAA compliance

Epic scheduling experience

Education

High school diploma or GED

Tools

Epic scheduling

Job description

Inova Health System in Virginia is seeking an Insurance Authorization Specialist Senior for a full-time, day-shift role with a hybrid schedule. The position collaborates with physicians and billing staff to manage complex pre-service authorizations and ensure timely patient access.

The ideal candidate will have at least four years in healthcare revenue cycle, payer policy experience, and Epic scheduling proficiency. Bilingual Spanish is a plus, and HIPAA compliance is essential.