Insurance Verification & Prior Authorization Specialist

Waccamaw Dermatology; Myrtle Beach (SC); On-site; USD 42,000 - 56,000; Full time

Job summary

Waccamaw Dermatology is seeking an organized Level I Billing Specialist to manage insurance verifications, prior authorizations, and patient account pre-collections. You will ensure timely processing of insurance documentation and communicate financial responsibilities to patients and providers.

The role requires knowledge of CPT/ICD-10 coding, HIPAA regulations, and experience with EHR systems. Strong communication and multitasking abilities are essential for success in this team-based clinic.

Qualifications

• High School diploma or equivalent required.
• Experience in healthcare billing, prior authorization, or collections preferred.
• Strong knowledge of medical terminology, coding (CPT, ICD-10), and HIPAA regulations.
• Proficiency with insurance verification processes and prior authorization workflows.
• Familiarity with EHR systems and medical billing software.
• Excellent written and verbal communication, plus strong interpersonal skills.
• Good organizational skills with the ability to manage multiple tasks and deadlines.
• Problem-solving mindset with proactive approach to challenges.

Responsibilities

• Manage insurance verifications and prior authorizations for services and medications.
• Determine when prior authorization is required and submit requests with supporting docs.
• Track status, follow up with insurers, and escalate complex cases as needed.
• Communicate authorization status and financial responsibility to patients and providers.
• Review patient accounts for overdue balances and discuss payment options or plans.
• Proactively contact patients about upcoming procedures requiring prepayment.
• Answer inquiries regarding billing statements, coverage, and financial responsibility.
• Maintain detailed records of authorization and collection activities.
• Generate reports on accounts receivable and denials trends; report to management.
• Stay updated on insurance policy changes and billing regulations.
• Collaborate with billing staff to resolve complex issues and ensure accurate claim submissions.
• Contribute to team goals and provide superior customer service at all times.

Skills

Healthcare billing

Prior authorization

Insurance verification

Medical terminology

CPT/ICD-10 coding

EHR systems

Communication skills

Organization skills

Education

High School diploma or equivalent

Job description

Waccamaw Dermatology is seeking an organized Level I Billing Specialist to manage insurance verifications, prior authorizations, and patient account pre-collections. You will ensure timely processing of insurance documentation and communicate financial responsibilities to patients and providers.

The role requires knowledge of CPT/ICD-10 coding, HIPAA regulations, and experience with EHR systems. Strong communication and multitasking abilities are essential for success in this team-based clinic.