oracle
Insurance Authorization Specialist
Inova
Virginia, USA
Full-time
Junior · 2+ years experience
Onsite
Discovered 1 weeks ago
Full Job Posting
Job Responsibilities
- Independently manages authorization and preservice financial clearance activities for moderate to complex specialty services, including surgeries, procedures, rehabilitation services, neurology services, recurring department services, and specialty clinic treatments.
- Performs detailed review of payer medical policies, insurance coverage requirements, and medical necessity criteria to ensure appropriate authorization submission and denial prevention.
- Coordinates closely with clinical schedulers, clinics, and operational teams to ensure service-line–specific authorization requirements and documentation standards are met.
- Manages authorization requests through payer portals and electronic workflows while proactively monitoring status and performing follow-up with insurance payers to facilitate timely approvals.
- Maintains a strong working knowledge of payer policies, insurance plans, and specialty service-line authorization requirements.
- Collaborates with operational teams to support workflow improvements related to authorization processing, preservice financial clearance, and patient access operations.
- May perform additional duties as assigned.
Additional Requirements
- Experience - 2 years of healthcare revenue cycle, patient access, authorizations, preservice financial clearance, or related healthcare operations
- Education - High school or GED
- Preferred Candidate Profile:
- Strong background in healthcare authorization, patient access, revenue cycle, or preservice financial clearance.
- Experience working with complex specialty services and payer authorization requirements.
- Knowledge of insurance eligibility, benefits verification, medical necessity guidelines, and financial counseling.
- Strong analytical, problem-solving, and customer service skills.
- Ability to work independently, manage multiple priorities, and thrive in a fast-paced healthcare environment.
About Inova
Hospitals & Health Systems26000 employeesFounded 1956
Nonprofit healthcare provider based in Northern Virginia.
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