Insurance Authorization Associate - Pre Service

Inova Health System•VA, VA

11d•$19 - $31•Hybrid

About The Position

Inova is looking for a dedicated Insurance Authorization Associate to join the team. This role will be full-time 9:30am - 6:00pm M-F/ Hybrid following initial 90-days on-site training. 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.

Requirements

1 year of healthcare revenue cycle, patient access, insurance verification, authorizations, or customer service experience
High school diploma or GED

Nice To Haves

Strong background in healthcare authorization, patient access, revenue cycle, or preservice financial clearance.
Experience working with complex specialty services and payer authorization requirements.
Knowledge of insurance eligibility, benefits verification, medical necessity guidelines, and financial counseling.
Strong analytical, problem-solving, and customer service skills.
Ability to work independently, manage multiple priorities, and thrive in a fast-paced healthcare environment.

Responsibilities

Performs standard payer authorization submissions for routine services, including imaging, procedures, surgeries, and admissions, following established workflows.
Processes high-volume, lower-complexity authorization and preservice financial clearance requests while maintaining productivity and quality standards.
Verifies patient eligibility and insurance benefits and ensures accuracy of demographic, insurance, and registration information to support clean authorization submissions.
Ensures required medical documentation and order information are complete prior to submission of authorization requests.
Submits authorization requests through payer portals, electronic workflows, or automated tools and tracks authorization status through completion.
Utilizes Epic workflows, automation tools, and decision support systems to support efficient authorization processing.
Escalates complex payer policy issues, medical necessity concerns, or cases requiring appeals or peer-to-peer review as appropriate.
Provides clear and professional customer service when communicating with patients regarding authorization requirements and financial responsibility.
Maintains foundational knowledge of insurance plans, payer policies, and pre-service authorization workflows.
May perform additional duties as assigned.