Top 384 Specialist remote Jobs in Washington, Dc

Referral Authorization Specialist
Samaritan —Washington, DC
- $21.24 - $28.84 an hour
- Full-time
- Remote
- Heavy lifting
- HIPAA
- Mid-level
Quick Apply
Senior Claim Benefit Specialist - Remote
CVS Health —Washington, DC
- $18.50 - $42.35 an hour
- Full-time
- Remote
- Mid-level
- High school diploma or GED
- Mentoring
- Health insurance
- Dental insurance
Program Support Specialist (Remote)
ICF —Reston, VA
- $50,605 - $86,028 a year
- Full-time
- Remote
- Microsoft Excel
- Mid-level
- Administrative experience
5d
Administrative Support Specialist
ARL Incorporated —Washington, DC
- Full-time
- Remote
- 5 years
- Office
- Bachelor's degree
Quick Apply
Talent Acquisition Specialist
Ledger Run Inc. —Washington, DC
- $80,000 - $100,000 a year
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Mid-level
Quick Apply
Pre-Registration Specialist, Per Diem
Samaritan —Washington, DC
- $21.10 - $26.26 an hour
- Part-time
- Remote
- Mid-level
- High school diploma or GED
- Mentoring
Quick Apply
Employment Service Specialist
ASHLIN Management Group, Inc. —Washington, DC
- $24 - $26 an hour
- Remote
- 5 years
- Computer literacy
- Presentation skills
Quick Apply
Contract Specialist-Mid-Remote
Integrity Management Consulting —Tysons, VA
- $70,000 - $85,000 a year
- Full-time
- Remote
- 5 years
- Bachelor's degree
- Contracts
Quick Apply
Docket Specialist
Keller Postman —Washington, DC
- $28 - $40 an hour
- Overtime
- Remote
- Microsoft Excel
- Microsoft Outlook
- Mid-level
Quick Apply
Leave Specialist - REMOTE
Ryder System —Washington, DC
- $55,000 a year
- Full-time
- Remote
- Microsoft Excel
- Mid-level
- Analysis skills
- Disability insurance
- Health insurance
Logistics Specialist - SBG REMOTE
SBG TECHNOLOGY SOLUTIONS INC —Alexandria, VA
- $95,000 - $110,000 a year
- Full-time
- Remote
- Background check
- Microsoft Excel
- Bachelor of Science
Licensed Professional Counselor
Headway —Arlington, VA
- Up to $126 an hour
- Remote
- Private practice
- Master's degree
- Senior level
Licensed Professional Counselor
Headway —Germantown, MD
- Up to $121.74 an hour
- Remote
- Private practice
- Master's degree
- Senior level
Licensed Professional Counselor
Headway —Waldorf, MD
- Up to $121.74 an hour
- Remote
- Private practice
- Master's degree
- Senior level
Licensed Professional Counselor
Headway —Washington, DC
- Up to $121.74 an hour
- Remote
- Private practice
- Master's degree
- Senior level
AI Annotation Specialist Data Science - AI Trainer
DataAnnotation —McLean, VA
- $50 - $100 an hour
- Part-time
- Remote
- Computer Science
- English
- Mid-level
- Flexible schedule
Quick Apply
AI Training Specialist Quantitative - AI Trainer
DataAnnotation —Rockville, MD
- $50 - $100 an hour
- Part-time
- Remote
- Computer Science
- English
- Mid-level
- Flexible schedule
Quick Apply
Implementation Specialist
Hendall Inc —Rockville, MD
- $70,000 - $95,000 a year
- Full-time
- Remote
- Microsoft Excel
- 5 years
- Public speaking
Quick Apply
Change Management Specialist
Gritter Francona —Washington, DC
- Full-time
- Remote
- Mid-level
- Bachelor's degree
- Continuous improvement
- AD&D insurance
- Disability insurance
Quick Apply
IT Specialist
One Federal Solution —Washington, DC
- Full-time
- Remote
- Microsoft Word
- Microsoft Excel
- Microsoft Access
Quick Apply

I want to receive the latest job alert for specialist remote in washington, dc

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

specialist remote jobs near washington, dc

Referral Authorization Specialist

Samaritan -
Washington, DC

Quick Apply

Job Details

Full-time
$21.24 - $28.84 an hour

Qualifications

Customer communication
High school diploma or GED

Full Job Description

Our Mission

All of us, for each of you, every time.

Our Vision

Together, serving as the trusted regional healthcare partner.

Our Values

Listen~Love~Respect~Excel~Innovate

Samaritan is searching for a Referral & Authorization Specialist to join our team! The Referral & Authorization Specialist is responsible for coordinating and securing prior authorizations, managing outgoing referrals, and ensuring compliance with payer requirements to support timely patient care and optimal reimbursement. This role serves as a critical liaison between providers, patients, payers, and internal departments to reduce denials, prevent delays in care, and ensure accurate documentation.

This is a full-time remote position that will be required to come on-site for onboarding and equipment pick-up (2 DAYS ONLY). This is a full-time role working Monday-Friday from 8:00 AM – 4:30 PM PST.

ESSENTIAL FUNCTIONS

Prior Authorization Management

Obtain prior authorizations for hospital and clinic services, including but not limited to, outpatient procedures, imaging, surgeries, and other specialty services.

Identify the health plan(s) by confirming information provided and verifying eligibility and coverage.

Verify payer requirements for authorization, referral, and medical necessity requirements based on plan guidelines.

Submit complete and accurate authorization requests with appropriate clinical documentation.

Track authorization status and follow up with the payer at regular intervals to ensure timely approvals.

Escalate urgent or complex cases to avoid delays in patient care.

Document authorization numbers, effective dates, and limitations in the EMR.

Communicate authorization delays and denials to ordering providers and clinics.

Monitor authorization workqueues and ensure timely completion.

Referral Management

Coordinate with providers and clinics to ensure appropriate scheduling and continuity of care.

Process outgoing referrals for specialty care.

Ensure referrals meet payer and regulatory requirements (e.g., PCP referrals, network rules).

Monitor referral workqueues and ensure timely completion.

Denial Prevention & Revenue Cycle Support

Review payer policies to ensure compliance and minimize denials.

Partner with coding, billing, and clinical teams to resolve authorization-related denials.

Inform department professionals and/or providers when peer-to-peer review is necessary. Assist as needed.

Assist with retro authorization requests and appeals as needed.

Identify trends and recommend process improvements.

Communication & Assistance

Serve as the point of contact for patients regarding referral and authorization status.

Communicate clearly with providers, clinical staff, payers, and patients.

Educate patients on authorization and referral procedures and next steps.

Maintain ongoing tracking and documentation for prior authorizations and referrals to promote team awareness.

Ensure HIPAA compliance when sharing patient information with authorized care providers.

General

Participate in continuing education opportunities.

Maintains professional growth and development through seminars, workshops and professional affiliations to keep abreast of latest trends in the field of expertise.

Ensures no injuries to self or others by following safe work practices and policies. This includes, but is not limited to: security and safety, understanding of chemical Safety Data Sheets (SDS), equipment, infection control, fire, disaster, safe lifting and body mechanics.

Ensures self-compliance with organization policies and procedures, as well as labor agreements.

Ensures the interface with team members and other support groups is conducted in a courteous and efficient manner conducive to the organization's values.

Conducts self in a professional manner and ensures personal appearance meets the standards necessary to perform the job function while representing the organization.

Ensures that additional accountabilities, as may be required by management, be handled in a manner necessary to meet organizational standards.

WORK ENVIRONMENT

The professional in this position reports to the Director of Revenue Cycle. Professionals in this position will work closely with patients and other Samaritan professionals within various departments.

EDUCATION & EXPERIENCE

Education:
- High school diploma or equivalent required; Associate degree preferred.
Experience:
- Minimum of two (2) years of experience in healthcare referrals, prior authorizations, or revenue cycle required.
- Experience working in a healthcare setting providing multi-specialty support preferred.
- Certified Healthcare Access Associate (CHAA) or similar certification preferred.
- Experience with Medicare, Medicaid (including Washington Apple Health), and commercial payers.
- Understanding of medical necessity criteria and utilization management.
Skills/Competencies:
- Strong knowledge of insurance plans, payer requirements, and authorization requirements.
- Familiarity with CPT, IDC-10, and medical terminology.
- Experience with EMR systems (EPIC) and payer portals (e.g., Availity, OneHealthPort, payer websites)
- Excellent organizational and time management skills.
- Ability to manage high-volume workqueues with attention to detail.
- Effective communication and interpersonal skills.
- Demonstrates competency on equipment listed on department specific checklist.
- Strong critical thinking skills: seeks resources for direction, when necessary. Performs independent problem solving. Decision-making is logical and deliberate.
- Performs actions that demonstrate accountability. Exercises safe judgment in decision-making. Practices within legal and ethical guidelines.
- Demonstrates competency in ability to care for customers/patients across the age continuum.

PHYSICAL REQUIREMENTS

Occasional lifting, reaching, kneeling, bending, stooping, pushing and pulling.

Occasional heavy lifting (lift/carry up to 50 lbs.).

Manual dexterity and mobility.

Ability to read and understand patient charts, provider orders, tests results, etc.

Ability to communicate using verbal and/or written skills for accurate exchange of information with physicians, nurses, health care professionals, patients and/or family, and the public.

As a Samaritan professional, you will be asked to carry out the Mission, Vision, Values, and Strategy of Samaritan, personifying service and operational excellence including the creation and maintenance of the best patient, professional, physician, and student experience.

Experience

Required

2 year(s): Experience in healthcare referrals, prior authorizations, or revenue cycle

Preferred

Experience with Medicare, Medicaid (including Washington Apple Health), and commercial payers.
Experience working in a healthcare setting providing multi-specialty support

Education

Required

High School or better

Preferred

Associates or better

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

Quick Apply

Refine Your Search

specialist remote jobs in washington, dc

Referral Authorization Specialist

Senior Claim Benefit Specialist - Remote

Program Support Specialist (Remote)

Administrative Support Specialist

Talent Acquisition Specialist

Pre-Registration Specialist, Per Diem

Employment Service Specialist

Contract Specialist-Mid-Remote

Docket Specialist

Leave Specialist - REMOTE

Logistics Specialist - SBG REMOTE

Licensed Professional Counselor

Licensed Professional Counselor

Licensed Professional Counselor

Licensed Professional Counselor

AI Annotation Specialist Data Science - AI Trainer

AI Training Specialist Quantitative - AI Trainer

Implementation Specialist

Change Management Specialist

IT Specialist

I want to receive the latest job alert for specialist remote in washington, dc

Related Searches

Explore jobs in more locations

Our Mission

Our Vision

Our Values

Experience

Education

Job Seeker Tools

Employer Tools

Browse

Stay Connected