Prior Authorization Specialist

*This is a remote job opportunity however you must sit in VA. You will need to have your own computer and reliable high speed internet. *

Insight Global is seeking a Pre- Authorization specialist for a large hospital system in Virginia. Obtains pre-certification for all inpatient admission and pre-authorization for all outpatient diagnostic tests and performs an administrative support function. This job requires the application and interpretation of policies and procedures and the use of independent judgment in a medical setting. The purpose is to achieve the goals and to meet the denial rates set by Patient Access the Medical Center and HSF to ensure minimum loss of revenue and maximum payment for services. The ability to maintain a working knowledge of carrier contracts/changes and departmental policies and procedures is required.

Job Description

* Analyzes information required to complete pre-certifications and/or authorizations with insurance carriers service area contacts and workman's compensation carriers.

* Demonstrates skill in the proficient use of PC and UVA software systems to ensure that all pre-certification/pre-authorization information is entered into required computer systems in an accurate and timely manner.

* Demonstrates the skills of effective communication decision-making and organization to ensure efficient job performance and job success.

* Demonstrates ability to adhere to policies and procedures.

* In addition to the above job responsibilities, other duties may be assigned.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com .

To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ .

Required Skills & Experience

Requirements:

* High school Diploma or equivalent

* 2 years of prior authorization experience

* Epic experience

Reliable computer and high speed internet

Nice to Have Skills & Experience

Plusses
Preferred qualifications
* Experience with CPT codes

Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.