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Director Prior Authorization Jobs in Reston, VA (NOW HIRING)

GI Alliance

Medical Assistant - Urology (30648)

Alexandria, VA · On-site

$18 - $23/hr

Obtains prior authorization for ordered imaging and prescriptions. * Checks physician voicemail 2-3 ... Administer medications and injections as directed by the urologist. 2. Clinical Support * Prepare ...

GI Alliance

Medical Assistant - Urology (32124)

Reston, VA · On-site

$18.50 - $23.75/hr

Obtains prior authorization for ordered imaging and prescriptions. * Checks physician voicemail 2-3 ... Administer medications and injections as directed by the urologist. 2. Clinical Support * Prepare ...

GI Alliance

Medical Assistant - Urology (31794)

Alexandria, VA · On-site

$18 - $23/hr

Obtains prior authorization for ordered imaging and prescriptions. * Checks physician voicemail 2-3 ... Administer medications and injections as directed by the urologist. 2. Clinical Support * Prepare ...

CareMetx

Director, End User Services

Bethesda, MD · On-site

... prior authorization. Our best-in-class patient support services enhance every step of care ... Director, End User Services POSITION SUMMARY: As Director, End User Services, you will lead ...

GI Alliance

Medical Assistant - Urology (32016)

Alexandria, VA · On-site

$18 - $23/hr

Obtains prior authorization for ordered imaging and prescriptions. * Checks physician voicemail 2-3 ... Administer medications and injections as directed by the urologist. 2. Clinical Support * Prepare ...

Sterling Senior Care

Admissions Director

Rockville, MD

  • Medical

  • Dental

  • Retirement

  • PTO

The Admissions Director is responsible for the overall development, coordination, and ... Verifying insurance benefits and authorization prior to admission * Ensuring a smooth transition ...

State Affairs

Sales Director

Washington, DC · On-site

$180K - $230K/yr

Prior professional work experience carrying and delivering against a meaningful quota ($800K-$1M ... Candidates must be authorized to work in the United States without the need for current or future ...

ITC Federal, Inc

Deputy Division Director

Fairfax, VA · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Deputy Division Director AGENCY SUPPORTED: U.S. Department of Justice (DOJ) - MEGA 6 Automated ... prior to start (candidates are not required to be cleared at the time of application). * Authorized ...

Socket.dev

Program Director

Alexandria, VA · On-site

$85 - $120/hr

Obtains initial Medicaid authorizations for all patients and provides UR with needed information ... Prior supervisory experience preferred * Demonstrated ability to perform under pressure

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All JobsPrior Authorization JobsDirector Prior Authorization JobsDirector Prior Authorization Jobs in Reston, VA

Director Prior Authorization information

What is the difference between Director Prior Authorization vs Medical Claims Supervisor?

AspectDirector Prior AuthorizationMedical Claims Supervisor
Required CredentialsBachelor's degree, industry certifications often preferredBachelor's degree, relevant certifications beneficial
Work EnvironmentHealthcare organizations, insurance companiesHealthcare providers, insurance companies
Employer & Industry UsageUsed in health insurance and healthcare managementCommon in healthcare administration and insurance claims processing
Primary FocusReviewing and approving prior authorization requestsOverseeing claims processing and ensuring accuracy

The main difference is that the Director Prior Authorization focuses on managing the approval process for medical procedures before they occur, while the Medical Claims Supervisor oversees the processing and accuracy of claims after services are provided. Both roles require healthcare knowledge, but their responsibilities and workflows differ significantly.

What are the most commonly searched types of Prior Authorization jobs in Reston, VA?

The most popular types of Prior Authorization jobs in Reston, VA are:

Director Prior Authorization jobs near you

Medical Assistant - Urology (30648)

GI Alliance

Alexandria, VA • On-site

$18 - $23/hr

Full-time

Re-posted 2 days ago

GI Alliance rating

6.4

Company rating: 6.4 out of 10

Based on 69 frontline employees who took The Breakroom Quiz

641st of 887 rated healthcare providers

Job description

Essential Job Responsibilities:
  1. Rooms patients during the clinic.
  2. Perform all necessary in-house testing prior to the physician seeing the patient, which include UA Dip, bladder ultrasound, uroflows.
  3. Nurse schedule as assigned: Catheter removals, catheter changes, BCG instillations, DMSO installations, Urocuff studies, bladder ultrasounds, other scheduled responsibilities.
  4. Preps and assists physicians with in-office procedures.
  5. Performs clerical duties related to clinical services including appointment scheduling, returning messages for patients as requested by physicians.
  6. Fills out FMLA or disability paperwork for assigned physicians.
  7. Performs medical receptionist duties as necessary: answers telephone, screens calls, takes messages, works on incoming faxes, takes payments, and provides information.
  8. Obtains, verifies, and updates patient information and provides support services to patients and medical staff.
  9. Obtains prior authorization for ordered imaging and prescriptions.
  10. Checks physician voicemail 2-3 times daily.
  11. Assists team's scribe with prescription refill requests.
  12. Works with the team's scribe to address physician's telephone encounters and documents.
  13. Performs daily assigned tasks related to JCAHO or CLIA compliance.
  14. Performs daily, weekly, and monthly cleaning of the clinical area as assigned by the clinical supervisor-including exam rooms, procedure rooms, patient restrooms, lab, and instrument cleaning area.
  15. Other duties as assigned by admin.

Performance Requirements:
1. Patient Care
  • Escort and prepare patients for examination or treatment.
  • Obtain and record vital signs, medical history, and other relevant patient information.
  • Assist urologists with procedures, examinations, and urological tests.
  • Educate patients on urological procedures, treatments, and post-care instructions.
  • Administer medications and injections as directed by the urologist.

2. Clinical Support
  • Prepare and maintain urology exam rooms with necessary supplies and equipment.
  • Sterilize and maintain medical instruments and equipment.
  • Perform basic diagnostic tests such as urinalysis and bladder scans.
  • Assist in urological diagnostic procedures, including cystoscopies and urodynamic studies.

3. Administrative Duties
  • Schedule appointments, surgeries, and follow-up visits for urology patients.
  • Manage patient records, ensuring accuracy and confidentiality.
  • Handle billing and coding related to urology procedures and visits.
  • Obtain and verify insurance information and process prior authorizations.
  • Answer phone calls, address patient inquiries, and provide information as needed.

4. Collaboration
  • Coordinate with other healthcare professionals, including nurses, physicians, and administrative staff.
  • Communicate effectively with patients to ensure they understand their treatment plans and follow-up instructions.
  • Assist in the coordination of care with external healthcare providers and specialists.

5. Equipment and Supplies
  • Maintain an inventory of urology-related supplies and reorder as necessary.
  • Ensure the proper functioning and calibration of urological equipment.
  • Report any equipment malfunctions or issues promptly.

6. Compliance and Quality Assurance
  • Adhere to all relevant healthcare regulations and protocols.
  • Maintain compliance with HIPAA regulations and patient privacy policies.
  • Participate in quality assurance initiatives and continuous improvement efforts.

Essential Knowledge, Skills and Abilities:
Knowledge:
  1. Medical terminology and office procedures.
  2. Grammar, spelling, and punctuation to type from draft copy and review/edit reports and correspondence.
  3. Basic arithmetic to make calculations, balance/reconcile figures, and make changes accurately.
  4. Medical assisting tasks including taking vital signs, drawing blood, lab processing, procedure prep, and RX prior authorizations.
  5. Healthcare systems, regulations, policies, and functions.
  6. Infection control and safety standards.

Skills:
  1. Operating office equipment.
  2. Organizational skills: time management, prioritization, multitasking, and problem-solving.
  3. Basic computer skills.

Abilities:
  1. Type 40 WPM using word-processing software; able to use Microsoft Excel, email, internet, PowerPoint.
  2. Read, understand, and follow oral and written instructions.
  3. Sort and file materials correctly using alphabetic or numeric systems.
  4. Communicate clearly and concisely.
  5. Establish and maintain effective working relationships with patients, physicians, clinical staff, and the public

Education:
High school diploma or GED. Diploma as a medical administrative assistant from an accredited medical vocational course preferred. Certification of CCMA, RMA, or CMA preferred.
Experience:
Minimum one year of administrative assistant experience in a medical office setting.
Equipment Operated:
Office machinery including computers, cystoscopy scopes/carts, ultrasound machines, autoclave, and instruments for several procedures.
Work Environment:
Work performed in an office environment with frequent contact with staff and patients.
Mental/Physical Requirements:
Manual dexterity for office machine operation, including computer and clinical equipment; stooping, bending, or standing for extended periods. Stress may be triggered by multiple staff demands and deadlines.

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