Prior Authorization Specialist

Skin And Cancer Institute; Lancaster (CA); Remote; USD 45,000 - 75,000; Full time

Job summary

An established industry player in dermatology is seeking dedicated professionals to join their team. This role focuses on managing prior authorizations and ensuring compliance with insurance policies. Candidates should have a strong background in healthcare management and excellent communication skills. The company offers a supportive work environment with competitive salary and benefits, including health insurance and professional development opportunities. If you're passionate about patient care and thrive in a collaborative setting, this opportunity is perfect for you.

Benefits

Health, dental, and vision insurance

401K retirement savings

Paid time off

Professional development opportunities

Supportive work environment

Qualifications

• 3+ years of experience in Prior Authorizations, preferably in dermatology.
• Strong understanding of healthcare management and patient accounts.
• Ability to educate patients on insurance processed claims.

Responsibilities

• Coordinate with insurance companies for pre-authorization of medical procedures.
• Review patient records to determine services requiring authorization.
• Maintain compliance with industry standards and regulations.

Skills

Prior Authorizations

Healthcare Management

Patient Communication

Attention to Detail

Team Leadership

Education

High School Diploma

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

EHR/PM system Modernizing Medicine/EMA

Job description

Join Our Team at Skin and Cancer Institute!

Are you passionate about dermatology and skin health? Do you thrive in a dynamic, patient-focused environment? Skin and Cancer Institute is looking for dedicated professionals to join our team!

Why Join Us?

At Skin and Cancer Institute, we are committed to excellence in dermatology, skin cancer treatment, and cosmetic procedures. We offer a supportive and collaborative work culture where your skills and dedication make a real impact.

What You’ll Do:

• Maintain current knowledge of insurance policies, regulations, and requirements to ensure compliance with industry standards.
• Ability to meet productivity and quality measurement requirements.
• Work collaboratively with extended prior authorizations team.
• Review patient medical records and insurance information to determine which services require authorization.
• Coordinate with the practices and insurance companies to obtain pre-authorization for medical procedures, treatments, and dedications.
• Communicate with patients and healthcare providers regarding the status of authorization requests and any changes in coverage.
• Participates in the development of coding and billing strategies, evaluating processes related to Revenue Cycle and making recommendations while ensuring compliance with any relevant rules or regulations (including HIPAA, Medicaid, Medicare, and specific 3rd Party Payors).
• Maintains professional relationships and collaborates across teams.
• Prepares and coordinates revenue cycle responsibilities within the acquisition/implementation process. This includes but is not limited to staff onboarding, vendor management, and clearinghouse management

What We’re Looking For:

• 3+ years of experience in Prior Authorizations, preferably in dermatology.
• Must have a high school diploma or equivalent educational experience.
• 3+ years of remote working experience.
• Demonstrate an understanding of healthcare management, including staffing and leadership.
• Demonstrate an understanding of patient accounts.
• Check Benefits and Eligibility (call insurance companies to verify certain information needed)
• Get authorization if needed
• Communicate with the patients.
• Collect payment from patient if needed (includes quote)
• Make sure that insurance information is correct in EMA
• Communicate with the SRT team so they can schedule the patient.
• Answer any and all Klara messages, or team's messages.
• Communicate with the MD's when needed
• Make sure that all documentation is in EMA.
• Continue to help and train Juliette where and when needed.
• Ability to educate patients on explanation of benefits for insurance processed claims.
• Communicate effectively with healthcare workers, patients and insurance companies.
• Able to prioritize and organize tasks at hand.
• Strong attention to detail, positive attitude and a proven ability to lead a team to success.
• Proficient in Microsoft Word, Outlook and Excel.
• Knowledge of state regulations.
• Experience with the EHR/PM system Modernizing Medicine/EMA is a plus

What We Offer:

• Competitive salary and benefits
• Health, dental, vision, and ancillary insurance options
• 401K retirement savings
• Paid time off
• Professional development opportunities
• Supportive and fair work environment

� Apply Today! Be a part of a dynamic team that’s transforming skin health. Submit your resume and cover letter to [e-mail]. We can't wait to meet you!

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