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Insurance Authorization Jobs in Virginia (NOW HIRING)

VSI

Insurance Authorization Specialist

Reston, VA · On-site

C. metropolitan area, is seeking an Insurance Authorization Specialist to join our team. This role is responsible for obtaining prior authorization for various medical procedures, services, and ...

Sentara Healthcare

Authorization Coordinator II

Norfolk, VA · On-site +1

$18 - $22.25/hr

Insurance Verification: Confirm patient insurance eligibility, benefits, and coverage details to ensure services are authorized appropriately. Documentation: Accurately record authorization numbers ...

New

Sentara Healthcare

Authorization Coordinator II

Norfolk, VA · On-site +1

$18 - $22.25/hr

Insurance Verification: Confirm patient insurance eligibility, benefits, and coverage details to ensure services are authorized appropriately. Documentation: Accurately record authorization numbers ...

New

Albanymed

Authorization Specialist I

Broadway, VA · On-site

$49K - $69K/yr

Insurance Verification and Benefit interpretation to discern insurance guidelines are being adhered to. Ability to interact with patients and stakeholders for the successful financial clearance will ...

New

Riverside

$16.80 - $21.83/hr

Obtains insurance authorizations as necessary. * Recommends to practice manager any process improvements needed to improve quality of service. Maintains appearance and cleanliness of the reception ...

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Insurance Authorization information

What is the 3 month rule for jobs?

In the context of insurance authorization jobs, the 3 month rule often refers to a policy where certain authorizations or approvals are valid for three months, requiring re-authorization afterward. This rule helps ensure that coverage and approvals are current and accurate, and employees in this role must monitor expiration dates and follow up for renewals or re-approvals as needed.

What does an insurance authorization specialist do?

An insurance authorization specialist reviews and obtains prior authorization from insurance companies to approve medical procedures, treatments, or services. They communicate with healthcare providers and insurers, ensure documentation is complete, and use billing or authorization software to facilitate approvals, helping to ensure timely patient care and reimbursement.

What is an Insurance Authorization job?

An Insurance Authorization job involves verifying patient insurance coverage and obtaining necessary approvals before medical services are provided. Professionals in this role communicate with insurance companies, healthcare providers, and patients to ensure procedures are covered. They also handle documentation, follow up on pending requests, and assist in resolving authorization issues. Strong attention to detail and knowledge of insurance policies are essential for success in this role.

What are the key skills and qualifications needed to thrive in the Insurance Authorization position, and why are they important?

To excel in Insurance Authorization, you generally need knowledge of healthcare insurance procedures, attention to detail, and experience with medical terminology or health administration. Familiarity with insurance verification systems, EHRs, and payer portals is highly valued, and some positions may require certification in medical billing and coding. Strong organizational skills, clear communication, and customer service orientation help set top performers apart. These competencies ensure accurate authorization processes, minimize claim denials, and maintain effective communication among patients, providers, and insurers.

Is prior authorization a stressful job?

Insurance authorization jobs can be stressful due to the need for accuracy, attention to detail, and managing deadlines. Employees often handle complex documentation and communicate with healthcare providers and insurance companies, which can contribute to workplace pressure. However, stress levels vary depending on the work environment and individual coping skills.

What are the typical challenges faced in an Insurance Authorization role, and how are they addressed?

Working in Insurance Authorization often involves navigating complex insurance policies, staying updated with changing payer requirements, and handling high volumes of patient cases within tight deadlines. Effective team collaboration and strong problem-solving skills are essential to resolve issues such as denied claims or missing documentation. Many employers provide initial and ongoing training, along with access to supervisors or a supportive team, to help address these challenges. By staying organized and proactive in communication, Insurance Authorization professionals can efficiently manage their workload and ensure timely patient care.

Do you need a degree to be a prior authorization specialist?

A degree is not typically required to become a prior authorization specialist, but relevant certifications, healthcare knowledge, and experience with insurance processes are often preferred. Strong communication skills and familiarity with medical billing and coding can improve job prospects. Employers may have varying educational requirements depending on the organization.
What are the most commonly searched types of Insurance Authorization jobs in Virginia? The most popular types of Insurance Authorization jobs in Virginia are:
What are popular job titles related to Insurance Authorization jobs in Virginia? For Insurance Authorization jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Insurance Authorization jobs in Virginia look for? The top searched job categories for Insurance Authorization jobs in Virginia are:
What cities in Virginia are hiring for Insurance Authorization jobs? Cities in Virginia with the most Insurance Authorization job openings:
Insurance Authorization jobs near you
Insurance Authorization Specialist

Insurance Authorization Specialist

VIRGINIA THERAPY & FITNESS CENTER

Reston, VA • On-site

$18.75 - $25/hr

Other

Retirement, PTO

Posted 11 days ago

Job description

Insurance Authorization Specialist

VSI (formerly the Virginia Spine Institute), the leading multidisciplinary spinal healthcare practice in the Washington D.C. metropolitan area, is seeking an Insurance Authorization Specialist to join our team. This role is responsible for obtaining prior authorization for various medical procedures, services, and medications.

This is a full-time position working out of our Reston office. The position offers competitive pay, full benefits, 401k plan with a Company match, and three weeks of paid time off. The ideal candidate will have exceptional customer service skills and phone etiquette.

Duties & Responsibilities

  • Responsible for facilitating prior authorization for a variety of services (surgery, injections, medications, imaging, etc.) in a timely manner and working efficiently to facilitate a final approval.
  • Ensures all pertinent medical documentation is accurate and complete prior to authorization submission.
  • Coordinates with workers' compensation case managers to streamline authorizations for care
  • Tracks and monitors prior authorization status throughout the insurance approval process.
  • Utilizes a thorough working knowledge of insurance plans and medical policies to complete prior authorization requirements.
  • Coordinates with clinical staff during the prior authorization process to include notification of prior authorization approvals and denials in addition to facilitating appeals and peer-to-peer reviews with the payer.
  • Responsible for insurance benefits verification.
  • Works directly with the Director of Billing to identify trends in denials and opportunities for improvement in the authorization process.
  • Provides superior customer service when communicating with patients to resolve all inquiries regarding insurance authorization requirements.

Skills/Qualifications/Behaviors:

  • Bachelors degree in business or related field
  • 1-3 years of billing or authorization experience in the healthcare industry
  • Familiarity in navigating the appeals process with insurances and external agencies
  • Solution oriented problem solver, helpful and strong organizational skills
  • Strong multitasking ability; detail oriented
  • Proficient with oral and written communication, articulate, professional and friendly

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