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Inova Fairfax Hospital 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: offering up 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: offering paid 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 daytoday 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 highacuity and specialty services requiring advanced medical policy interpretation and crossfunctional 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:
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