Senior Insurance Authorization Specialist

Inova Fairfax Hospita is looking for a dedicated Insurance Authorization Specialist to join the team. This role will be Fulltime Monday-Friday

Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation.

Featured Benefits:

• Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program.
• Retirement:Inova matches the first 5% of eligible contributions - starting on your first day.
• Tuition and Student Loan Assistance: offering up to $5,250 per year in education assistance and up to $10,000 for student loans.
• Mental Health Support:offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost.
• Work/Life Balance:offering paid time off, paid parental leave, flexible work schedules, and remote and hybrid career opportunities.

Insurance Authorization Specialist 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.
• Performs advanced eligibility and benefits review to validate insurance coverage and financial readiness prior to service.
• Provides estimate review, financial counseling support, and handles patient inquiries related to estimates, insurance coverage, authorization requirements, and anticipated out-of-pocket responsibility while delivering strong customer service.

Minimum Requirements:

High School or GED

2 years Healthcare revenue cycle, patient access, authorizations, preservice financial clearance, or related healthcare operations