Top 88 Prior authorization specialist Jobs in Virginia

Authorization & Verification Specialist - Acute Team
ContinuumRx —Chantilly, VA
- Full-time
- Microsoft Word
- Microsoft Excel
- HIPAA
Quick Apply
Intake and Authorization Specialists
University of Virginia —Charlottesville, VA
- $24.50 - $45.68 an hour
- Online Application
- Mid-level
- 3 years
- Bachelor's degree
- Disability insurance
- Health insurance
Reimbursement Specialist Supervisor - Remote
VCU Health System —Richmond, VA
- Full-time
- Remote
- Mid-level
- 3 years
- High school diploma or GED
Insurance Authorization Specialist
VSI —Reston, VA
- From $23 an hour
- Full-time
- Mid-level
- Office
- Bachelor's degree
- Paid time off
- 401(k) matching
Quick Apply
20h
scheduling specialist
RAYUS Radiology —Woodbridge, VA
- Full-time
- Bilingual
- Computer literacy
- High school diploma or GED
- Paid holidays
- Disability insurance
Quick Apply
Patient Care Specialist
Sentara Hospitals —Norfolk, VA
- Full-time
- Mid-level
- 3 years
- High school diploma or GED
- 403(b) matching
- Paid parental leave
Quick Apply
Pre-Authorization Specialist (Onsite) - Augusta Health
Augusta Health —Fishersville, VA
- $17.98 - $24.81 an hour
- Full-time
- Microsoft Outlook
- Psychiatry
- Mid-level
- Free parking
- Health insurance
Quick Apply
14d
Pre-Visit Specialist I - Hospital Call Center (Scheduling & Pre-Registration)
Augusta Health —Fishersville, VA
- $17.72 - $24.46 an hour
- Full-time
- Hybrid work
- Psychiatry
- No experience needed
- High school diploma or GED
- Free parking
- Health insurance
Quick Apply
2d
Intake Specialist (In-Office if Local / Remote if Non-Local)
UNITED WOUND HEALING PS —Roanoke, VA
- $19 - $23 an hour
- Overtime
- Microsoft Outlook
- Pass drug screening
- HIPAA
- AD&D insurance
- Paid holidays
Quick Apply
Intake and Staffing Coordinator
Prospect Homecare Agency —Fairfax, VA
- $20 - $30 an hour
- 8 hour shift
- Background check
- Customer service
- Medical office experience
- Health insurance
- Dental insurance
Quick Apply
Behavioral Health Billing Specialist
Panacea Behavioral Health & Wellness Center —Virginia Beach, VA
- $21 - $24 an hour
- Full-time
- Private practice
- Mid-level
- In-person
- Health savings account
- Health insurance
Quick Apply
8d
Dental Insurance Coordinator -Chester
Virginia Family Dentistry —Chester, VA
- $20 - $25 an hour
- Full-time
- Dental office
- Ability to walk for extended periods
- Mid-level
- Profit sharing
- Paid holidays
Quick Apply
Patient Service Representative (PSR) - In Motion Physical Therapy - Town Center
Bon Secours —Virginia Beach, VA
- $16.76 - $24.65 an hour
- Research
- High school diploma or GED
- Rehabilitation center
- Health savings account
- Disability insurance
Pre-Authorization & Surgical Scheduler
82 Capital Women's Care —Fairfax, VA
- $24 - $26 an hour
- Full-time
- Background check
- Spanish
- Surgery
- Health savings account
- Health insurance
Quick Apply
9d
Applications Analyst, Senior - Willow, Willow Ambulatory, Specialty Pharmacy - Remote
VCU Health System —Richmond, VA
- Full-time
- Remote
- Computer Science
- Research
- 3 years
Surgery Scheduler
OrthoVirginia Inc —Lynchburg, VA
- $17.98 - $26.97 an hour
- Full-time
- Surgery
- Medical office experience
- Mid-level
Quick Apply
8d
Billing Specialist
Blue Ridge Behavioral Healthcare —Roanoke, VA
- $42,448.44 - $45,890.21 a year
- Full-time
- Hybrid work
- Background check
- Pass drug screening
- Research
- Paid holidays
- Paid time off
8d
Epic Ambulatory Bones Application Engineer Specialist - 6079188
Accenture —Arlington, VA
- $47.85 - $57.85 an hour
- Full-time
- Remote
- 5 years
- High school diploma or GED
- US work authorization
- Disability insurance
- Health insurance
Medical Accounts Receivable Specialist
M2 Orthopedic Partners MSO LLC —Arlington, VA
- Full-time
- OSHA
- Computer literacy
- Basic math
Quick Apply
Surgical Coordinator - Hybrid
Pelvic Rehabilitation Medicine —Falls Church, VA
- $24 - $28 an hour
- Full-time
- Hybrid work
- Surgery
- Physical & Rehabilitation Medicine
- Mid-level
Quick Apply
8d

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Authorization & Verification Specialist - Acute Team

ContinuumRx -
Chantilly, VA

Quick Apply

Job Details

Full-time

Qualifications

Microsoft Word
Microsoft Excel
Overseeing health insurance pre-certification
Serving clients
Presentation software

Full Job Description

Continuumrx is currently recruiting employees in Virginia to support our Acute Authorization and Verification Team!

Job Summary:

The Verification Specialist - Specialty role is responsible for processing benefit verification of benefits for acute patients.
The primary role of the Authorization Specialist is to review, process, and follow to completion the requirement of obtaining prior authorizations for services. This includes PBM authorizations.

Verification Specialist Roles and Responsibilities:

Verifies benefit coverage and as appropriate, financial responsibility.
Identifies out-of-pocket co-pays, deductibles, and co-insurance prior to services rendered in accordance with the insurance eligibility/coverage information provided by payor at time of insurance verification.
Documents all patient interaction in EMR as a billing note.
Serves as a resource and problem resolution expert for patients, Intake and Sales.
As needed, verifies insurance coverage and eligibility through payor websites, E1 check, or by calling the payor directly. Document information in EMR and communicates as appropriate to team members.
Assists with Ready To Bill (RTB) as appropriate.
Performs other duties and special projects, as assigned.
Complete understanding of confidentiality with respect to Company proprietary information as well as information concerning patient/client care; complying with all federal and state laws as apply to confidentiality of protected health information (PHI) and electronic protected health information (EPHI); and following HIPAA guidelines regarding readily identifiable protected health information.

AuthorizationSpecialist Roles and Responsibilities:

Coordinates with the Intake Specialists and the Pharmacy Team to identify and process requests for services requiring Prior Authorization and/or Pre-Determination for services rendered.
Reviews each request for Prior Authorization and insures that the proper supporting documentation and forms/documents are completed.
Processes Prior Authorizations via Fax, computer or phone call as required by the specific payers.
Maintains an organized process for documenting and tracking all requested prior authorizations.
Maintains an organized process for timely follow-up and troubleshooting of all pending Prior Authorizations.
Documents in the patient record all prior authorizations, expiration dates and other information as required.
Communicates with the Revenue Cycle Team and Admission Specialists any prior authorization denials and insures prompt follow-up.
Maintains a process to review newly accepted patients for a “second check” to prevent missing prior authorization requests.
Effectively identify and communicate to supervisor when assistance is needed (including, but not limited to system function, training, etc.).
Observes legal and ethical guidelines for safeguarding patient and company confidentiality (HIPAA).
Understands and provides exceptional customer service to clients, patients, and payers.
Exhibits a positive, courteous, respectful and helpful attitude to clients, co-workers, and management team.
Promotes company culture by adhering to all policies and procedures.
Adapts to and demonstrates the ability to deal with frequent changes in the work environment.
Other tasks/duties as assigned.
Complete understanding of confidentiality with respect to Company proprietary information as well as information concerning patient/client care; complying with all federal and state laws as apply to confidentiality of protected health information (PHI) and electronic protected health information (EPHI); and following HIPAA guidelines regarding readily identifiable protected health information.

Qualifications and Experience:

Required:

2 or more years of experience in healthcare reimbursement with focus on insurance verification and authorizations.
Experience with coordination of benefits, including but not limited to HMO, PPO, TPA, state and federal payors; preferred but not required.
Prior work in specialty or home infusion, homecare or related field; preferred but not required.
Strong computer skills (Microsoft Word, Excel, PowerPoint)
Exceptional communication - verbal and written
Exceptional interpersonal skills
Exceptional organizational and process skills
Ability to work well under pressure, meet timelines, and completes assigned projects
Exceptional critical thinking and problem solving skills
Proven performance, history in related field Exceptional attention to detail and demonstrated results
Exceptional track record of customer satisfaction

Quick Apply

Refine Your Search

prior authorization specialist jobs in virginia

Authorization & Verification Specialist - Acute Team

Intake and Authorization Specialists

Reimbursement Specialist Supervisor - Remote

Insurance Authorization Specialist

scheduling specialist

Patient Care Specialist

Pre-Authorization Specialist (Onsite) - Augusta Health

Pre-Visit Specialist I - Hospital Call Center (Scheduling & Pre-Registration)

Intake Specialist (In-Office if Local / Remote if Non-Local)

Intake and Staffing Coordinator

Behavioral Health Billing Specialist

Dental Insurance Coordinator -Chester

Patient Service Representative (PSR) - In Motion Physical Therapy - Town Center

Pre-Authorization & Surgical Scheduler

Applications Analyst, Senior - Willow, Willow Ambulatory, Specialty Pharmacy - Remote

Surgery Scheduler

Billing Specialist

Epic Ambulatory Bones Application Engineer Specialist - 6079188

Medical Accounts Receivable Specialist

Surgical Coordinator - Hybrid

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