Virginia Heart
Join to apply for the
Pre-Authorization Specialist
role at
Virginia Heart
Location: Falls Church, Fairfax, VA Status: Full-Time/Non-Exempt
At Virginia Heart, we are looking for a
Pre-Authorization Specialist
to obtain Pre-Authorizations for patient procedures and provide support to the office manager, physicians, billing, clinical staff, referring physicians and most importantly, the patient. The Specialist must have a high level of accuracy and precision in work, exude teamwork, and provide superior customer service to meet co-worker and patient needs.
Benefits
No Nights, weekends or holidays!
Affordable Medical, Dental and Vision plans
401(k) Retirement Plan
Paid Short-Term Disability
Employee Assistance Program for mental and physical well-being
Three Weeks of Paid Vacation upon eligibility
One week of Paid Sick Leave
Annual Merit-Based increases
Career Advancement Opportunities
Employee Referral Bonuses
Employee Discount Programs
Quarterly Employee Appreciation; events to include therapy dogs, raffles, and other fun events
Responsibilities
Manage all aspects of obtaining Pre-Authorization prior to patient procedures (in-office, hospital procedures, external imaging).
Work as a team within the department and with other Virginia Heart departments (Patient Services, Billing, Hospital Scheduling, Office Managers, physicians) and referring offices.
Request medical records within Virginia Heart, from referring offices, and surrounding hospitals.
Contact insurance companies via phone and insurance web‑based systems.
Verify patients' insurance and relay proper CPT codes/diagnosis codes to insurance companies for Pre-Authorization approval and/or referrals.
Identify all accepted insurance plans and cards.
Check insurance eligibility; obtain patient insurance referrals as needed. Interpret and use Virginia Heart’s demographic charts.
Act as a liaison between insurance companies, Virginia Heart physicians, and patients (peer‑to‑peer process).
Answer phones in a courteous, professional, and timely manner.
Provide friendly and efficient telephone services to patients and Virginia Heart staff and transfer calls as appropriate.
Demonstrate professionalism in all interactions with patients, vendors, and fellow employees to create a positive experience.
Exude confidence on the telephone fostering reassurance for our patients.
Resolve issues appropriate to position.
Requirements
HS Diploma or equivalent required
CPT and ICD‑10 CM coding criteria and guidelines preferred (preferably in cardiology)
Proficient in Microsoft Excel and Word required
EPIC experience preferred
Minimum of 1 year experience in a customer‑service related field, preferably a fast‑paced environment
Knowledge of insurance carriers, carrier websites, coverage policies and benefits
Ability to read EOB and explain definition of out‑of‑pocket, deductible, and co‑insurance
Seniority Level Entry level
Employment Type Full-time
Job Function Other
Industries Medical Practices
Referrals increase your chances of interviewing at Virginia Heart by 2x
Get notified about new Specialist jobs in Falls Church, VA.
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Pre-Authorization Specialist
role at
Virginia Heart
Location: Falls Church, Fairfax, VA Status: Full-Time/Non-Exempt
At Virginia Heart, we are looking for a
Pre-Authorization Specialist
to obtain Pre-Authorizations for patient procedures and provide support to the office manager, physicians, billing, clinical staff, referring physicians and most importantly, the patient. The Specialist must have a high level of accuracy and precision in work, exude teamwork, and provide superior customer service to meet co-worker and patient needs.
Benefits
No Nights, weekends or holidays!
Affordable Medical, Dental and Vision plans
401(k) Retirement Plan
Paid Short-Term Disability
Employee Assistance Program for mental and physical well-being
Three Weeks of Paid Vacation upon eligibility
One week of Paid Sick Leave
Annual Merit-Based increases
Career Advancement Opportunities
Employee Referral Bonuses
Employee Discount Programs
Quarterly Employee Appreciation; events to include therapy dogs, raffles, and other fun events
Responsibilities
Manage all aspects of obtaining Pre-Authorization prior to patient procedures (in-office, hospital procedures, external imaging).
Work as a team within the department and with other Virginia Heart departments (Patient Services, Billing, Hospital Scheduling, Office Managers, physicians) and referring offices.
Request medical records within Virginia Heart, from referring offices, and surrounding hospitals.
Contact insurance companies via phone and insurance web‑based systems.
Verify patients' insurance and relay proper CPT codes/diagnosis codes to insurance companies for Pre-Authorization approval and/or referrals.
Identify all accepted insurance plans and cards.
Check insurance eligibility; obtain patient insurance referrals as needed. Interpret and use Virginia Heart’s demographic charts.
Act as a liaison between insurance companies, Virginia Heart physicians, and patients (peer‑to‑peer process).
Answer phones in a courteous, professional, and timely manner.
Provide friendly and efficient telephone services to patients and Virginia Heart staff and transfer calls as appropriate.
Demonstrate professionalism in all interactions with patients, vendors, and fellow employees to create a positive experience.
Exude confidence on the telephone fostering reassurance for our patients.
Resolve issues appropriate to position.
Requirements
HS Diploma or equivalent required
CPT and ICD‑10 CM coding criteria and guidelines preferred (preferably in cardiology)
Proficient in Microsoft Excel and Word required
EPIC experience preferred
Minimum of 1 year experience in a customer‑service related field, preferably a fast‑paced environment
Knowledge of insurance carriers, carrier websites, coverage policies and benefits
Ability to read EOB and explain definition of out‑of‑pocket, deductible, and co‑insurance
Seniority Level Entry level
Employment Type Full-time
Job Function Other
Industries Medical Practices
Referrals increase your chances of interviewing at Virginia Heart by 2x
Get notified about new Specialist jobs in Falls Church, VA.
#J-18808-Ljbffr