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Intake Prior Authorization Jobs in Washington (NOW HIRING)

Community Options

Intake Coordinator

Gaithersburg, MD · On-site

$19.50 - $26.50/hr

Assure service authorizations in Therap are created and maintained to avoid loss of services and ... prior to an admission * Enroll/Admit all individuals into Therap * Assure new residents and ...

Community options

Intake Coordinator

Gaithersburg, MD · On-site

$19.50 - $26.50/hr

Assure service authorizations in Therap are created and maintained to avoid loss of services and ... prior to an admission * Enroll/Admit all individuals into Therap * Assure new residents and ...

UHS

Intake Registered Nurse

Washington, DC · On-site

$37.60 - $56.40/hr

The RN - Intake works with the Business Office regarding patient financial data and verification and prior authorization of insurance benefits as needed, as well as with the UR Department for the ...

UHS

Intake Registered Nurse

Washington, DC

The RN - Intake works with the Business Office regarding patient financial data and verification and prior authorization of insurance benefits as needed, as well as with the UR Department for the ...

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Intake Prior Authorization information

What are the key skills and qualifications needed to thrive as an intake prior authorization specialist?

To thrive as an Intake Prior Authorization Specialist, you need a strong understanding of insurance policies, medical terminology, and healthcare processes, often supported by a background in healthcare administration or a related field. Familiarity with prior authorization software, electronic medical records (EMRs), and payer portals is essential. Attention to detail, problem-solving abilities, and effective communication are crucial soft skills for navigating complex insurance requirements and collaborating with providers. These skills ensure timely and accurate processing of prior authorizations, reducing delays in patient care and supporting organizational efficiency.

What is an intake prior authorization specialist?

An Intake Prior Authorization Specialist is a healthcare professional responsible for processing and obtaining prior authorizations for medical procedures, medications, or services. They review requests from healthcare providers to ensure that the necessary documentation is provided and that the requested services meet insurance guidelines. This specialist acts as a liaison between providers, patients, and insurance companies to facilitate timely approvals and avoid delays in patient care. Their work helps ensure insurance coverage and compliance with healthcare regulations.

What are some common challenges faced in an intake prior authorization role, and how can they be managed?

Professionals in Intake Prior Authorization often navigate high volumes of requests, rapidly changing insurance guidelines, and tight turnaround times. Staying organized, maintaining up-to-date knowledge of payer requirements, and using strong communication skills can help manage these challenges. Collaborating closely with clinical and administrative teams is also key to ensuring timely and accurate processing of authorizations. Regular training and support from experienced colleagues can further ease the transition into this fast-paced environment.

What is the difference between Intake Prior Authorization vs Medical Office Assistant?

AspectIntake Prior AuthorizationMedical Office Assistant
CredentialsTypically requires knowledge of insurance policies, medical terminology, and sometimes certification in healthcare administrationHigh school diploma or equivalent; may have medical assisting certification
Work EnvironmentHealthcare facilities, insurance companies, or specialty clinicsMedical offices, clinics, hospitals
Primary ResponsibilitiesReviewing insurance requirements, obtaining prior authorizations, verifying patient insuranceScheduling appointments, patient check-in, data entry, administrative support

Intake Prior Authorization specialists focus on insurance approval processes, while Medical Office Assistants handle broader administrative tasks. Both roles are essential in healthcare settings but serve different functions related to patient intake and administrative support.

What are popular job titles related to Intake Prior Authorization jobs in Washington? For Intake Prior Authorization jobs in Washington, the most frequently searched job titles are:
What job categories do people searching Intake Prior Authorization jobs in Washington look for? The top searched job categories for Intake Prior Authorization jobs in Washington are:
What cities in Washington are hiring for Intake Prior Authorization jobs? Cities in Washington with the most Intake Prior Authorization job openings:
Intake Prior Authorization jobs near you

PDN Home Health Authorization Specialist

COMFORT HOME HEALTH LLC

Falls Church, VA • On-site

$25 - $30/hr

Full-time

Medical, Retirement

Posted 3 days ago

New

Job description

Benefits:
  • 401(k)
  • Competitive salary
  • Training & development

Job Summary
VitalCare Home Health LLC is seeking an experienced Authorization Specialist to join our growing Home Health team. The Authorization Specialist is responsible for obtaining, tracking, and managing insurance authorizations for skilled nursing and private duty nursing services. This position works closely with physicians, case managers, Medicaid Managed Care Organizations (MCOs), clinical staff, and families to ensure timely authorization approvals and uninterrupted patient care.
Responsibilities
* Submit initial and continued authorization requests.
* Track authorization expiration dates and renewals.
* Verify Medicaid and insurance eligibility.
* Communicate with MCOs regarding authorization status.
* Coordinate with physicians to obtain required documentation.
* Review nursing assessments and physician orders for completeness.
* Monitor pending authorizations and follow up to prevent delays.
* Resolve authorization denials and submit additional documentation when required.
* Maintain accurate documentation in Alora Plus EMR.
* Collaborate with Intake, Clinical Managers, and Scheduling staff.
* Maintain HIPAA compliance and confidentiality.
Preferred Experience
* Home Health or Private Duty Nursing (PDN)
* Virginia Medicaid
* CCC Plus
* DMAS documentation
* Prior Authorization
* Insurance Verification
* Alora Plus EMR (preferred)
Required Qualifications
* Minimum 2 years of Home Health authorization experience.
* Experience with Virginia Medicaid and Managed Care Organizations.
* Strong knowledge of authorization processes.
* Excellent organizational and communication skills.
* Ability to manage multiple authorizations simultaneously.
* Strong computer skills and attention to detail.
Preferred Payers Experience
* Anthem HealthKeepers Plus
* Sentara Health Plans
* Molina Healthcare
* Aetna Better Health of Virginia
* UnitedHealthcare Community Plan
Benefits
* Competitive salary
* 401(k)
* Professional Development Opportunities
Skills
* Prior Authorization
* Home Health
* Medicaid
* Insurance Verification
* Medical Documentation
* EMR
* Alora Plus
* HIPAA
* Microsoft Office
* Customer Service
* Communication
* Time Management
* Attention to Detail
* Problem Solving
Nice-to-Have
* Bilingual (English/Spanish)
* Experience with pediatric skilled nursing
* Experience with ventilator, trach, and G-tube cases
* Experience working with Medicaid waiver programs

Flexible work from home options available.