Senior Pre-Authorization Specialist - Healthcare Access

Universal Health Services; Washington (District of Columbia); On-site; USD 60,000 - 85,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision plan

401(k) with company match

Paid time off

Tuition reimbursement

SoFi student loan refinancing program

Employee assistance program

Career development opportunities

Job summary

The Pre-Authorization Specialist at George Washington University Hospital identifies prior authorization requirements and coordinates with insurers to obtain authorizations for scheduled and add-on services. Documentation occurs in CERNER and EPIC, with clear communication to the ordering provider about approvals or denials, and peer-to-peer reviews as needed.

Working at a leading academic medical center in downtown Washington, DC, this role supports optimal patient access and payer relations,

Qualifications

• Five (5) years' experience in a health care facility or equivalent position performing same or similar job duties required.
• CHAA - (Certified Healthcare Access Associate) certification preferred.

Responsibilities

• Identify prior authorization requirements by insurer/payer for scheduled and add-on services.
• Obtain pre-authorization and document information in CERNER and EPIC.
• Communicate outcomes to ordering providers and facilitate peer-to-peer reviews to prevent denials and improve physician satisfaction.

Skills

Communication

Attention to detail

Teamwork

Education

Associate degree in business or related major

Tools

CERNER

EPIC

Job description

The Pre-Authorization Specialist at George Washington University Hospital identifies prior authorization requirements and coordinates with insurers to obtain authorizations for scheduled and add-on services. Documentation occurs in CERNER and EPIC, with clear communication to the ordering provider about approvals or denials, and peer-to-peer reviews as needed.

Working at a leading academic medical center in downtown Washington, DC, this role supports optimal patient access and payer relations,