Remote Cigna Prior Authorization Jobs in Reston, VA

Inova Health is looking for a dedicated Patient Service Representative 3 to join the team. This hybrid role will be full-time day shift from Monday - Friday between Business Hours. (Must Report On-Site As Needed)

Remote Eligibility: This position is eligible for remote/hybrid work for candidates residing in the following states - VA, MD, DC, DE, FL, GA, NC, OH, PA, SC, TN, TX, WV

The Patient Service Representative 3 provides excellent service by identifying patient needs and fulfilling patient expectations. Responsible for patient inbound call support while completing assigned activities related to patient scheduling across a minimum of three departments. Verifies and enters insurance information and authorization/referral requirements into databases. Supports patient outreach initiatives, team projects, and support other team members with escalation calls or questions. Ensures a safe patient care environment to the fullest potential, in an effort to achieve team goals.

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, and flexible work schedules

Patient Service Representative 3 Job Responsibilities:

• Works independently to complete incoming calls without close supervision; Delivers an acceptable volume of work with high levels of accuracy while improving inefficiencies and minimizing repetitive errors by revising current workflow procedures.

  Selects an appropriate method of communication for audiences and adjusts communication style when needed. 

Follows EPIC scheduling process to identify the best provider for the patient's appointment needs. 

Exceeds all contact center metric goals to ensure calls are handled effectively and efficiently; includes Availability Rate, Avoidance Rate, First Call Resolution, Patient Survey Responses and Quality Assurance Scores. 

Interviews patients to secure and document required medical, financial, demographic and insurance information. 

Navigates communication for Patient to Practice/Clinic Front Desk, Nurses, and Physicians for any medical or appointment needs. 

Ensures needed internet services to work successfully from home, and if not able to work remote due to equipment or service issues, will report to an identified location to provide patient and team support. 

Communicates scheduling changes to patients, staff, physicians and patient representatives in a timely and professional manner. 

Supports primary department and provides additional support coverage to two additional departments assigned based on staffing needs; also includes Patient Outreach support for primary department. 

May assist with new hire training as well as assisting other contact centers based on staffing needs. 

May perform additional duties as assigned.

Minimum Qualifications:

• Experience  - 2 years healthcare or relevant experience. Or bachelor's degree in lieu of experience. 
• Education: High School or GED

Preferred Qualifications:

• Bilingual proficiency (Spanish) to support a diverse patient population
• Experience working with Primary Care, including scheduling, authorizations, or specialty workflows
• Prior patient scheduling experience in a healthcare, clinic, or hospital setting. 
• Experience providing telephonic support to patients, including handling high call volumes and navigating sensitive conversations. 
• Proficiency with Epic (EPIC) scheduling modules, including appointment scheduling, registration updates, and navigation of patient records. 
• Ability to multitask, manage competing priorities, and maintain accuracy in a fastpaced environment. 
• Strong attention to detail and commitment to patient confidentiality and HIPAA compliance.

We are Inova, Northern Virginia's leading nonprofit healthcare provider. Every day, our 26,000+ team members provide world-class healthcare to the communities we serve. Our people are the reason we're a national leader in healthcare safety, quality and patient experience. And from best-in-class facilities to professional development opportunities, we support them at every step. At Inova, we're constantly striving to be ever better - to shape a more compassionate future for healthcare. 

Inova Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, pregnancy (including childbirth, pregnancy-related conditions and lactation), race, religion, sex, sexual orientation, veteran status, genetic information, or any other characteristics protected by law.