Insurance Authorization Lead

Inova FairfaxHospital is looking for a dedicated Insurance Authorization Lead to join the team. This role will be Hybrid; Monday-Friday, 9:00 AM – 5:30 PM with an occasional rotating weekend shift (Saturday).

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.

Featured Benefits:

• **Committed to Team Member Health:**offering medical, dental and vision coverage, and a robust team member wellness program.
• **Retirement:**Inova matches the first 5% of eligible contributions – starting on your first day.
• **Tuition and Student Loan Assistance:**offeringup to $5,250 per year in education assistance and up to $10,000 for student loans.
• **Mental Health Support:**offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost.
• Work/Life Balance:offeringpaid time off, paid parental leave, flexible work schedules, and remote and hybrid career opportunities.

Insurance Authorization Lead Job Responsibilities:

• Serves as the primary team lead and operational resource, providing day‑to‑day guidance on workflows, payor requirements, authorization processes, preservice financial clearance, and estimate workflows.
• Oversees team productivity, work queues, turnaround times, and performance metrics—including authorization timeliness, clearance completion, estimate accuracy, and denial prevention—to ensure service level and operational standards are met.
• Performs and supports complex authorization activities across multiple service lines, including high‑acuity and specialty services requiring advanced medical policy interpretation and cross‑functional coordination.
• Ensures preservice workflows are completed accurately and timely, including authorizations, medical necessity validation, financial clearance, and patient responsibility estimates in alignment with financial transparency standards.
• Conducts routine quality audits of authorization, preservice, and estimate processes to ensure accuracy, compliance with payor guidelines, and adherence to organizational policies.
• Analyzes workflow outcomes, denial trends, and operational gaps to identify root causes and recommend process improvements, automation opportunities, and workflow optimization initiatives.
• Provides mentoring, coaching, and onboarding support to strengthen team knowledge and performance; serves as a liaison between frontline staff and leadership while providing operational coverage as needed to maintain workflow continuity.
• Oversees and assists team members in assigned functional area, which may include but not limited to, ensuring team is meeting key-deliverables and quality standards, addressing and resolving challenges, managing and tracking performance, and assisting in time management and scheduling; escalates issues to senior leaders as needed.
• May perform additional duties as assigned.

Minimum Qualifications:

• **Education:**High School or GED
• **Experience:**Five (5) years of healthcare revenue cycle, patient access, authorizations, preservice financial clearance, or related healthcare operations

Preferred Qualifications:

• • Experience: Authorization experience on payer portals; Oncology experience is a plus
• • Other: Comfortability in training other staff members & working on a team