Treatment and Authorization Representative

Waccamaw Dermatology; Myrtle Beach (SC); Hybrid; USD 48,000 - 60,000; Full time

Job summary

Waccamaw Dermatology seeks a Treatment & Authorization Representative to serve as the primary patient contact after diagnosis, communicating test results and educating on treatment plans. You will coordinate follow-up care, schedule procedures, and manage insurance authorizations to ensure timely access to therapies.

The role requires dermatology experience, medical terminology proficiency, and strong communication and organizational skills.

Qualifications

• Medical Assistant certification or equivalent clinical experience preferred.
• Dermatology exposure is strongly preferred.
• Prior authorization experience preferred; biologics experience is a plus.
• Strong understanding of medical terminology.
• Excellent communication, organization and customer service skills.
• Ability to multitask and prioritize in a fast-paced environment.
• Experience with EMR systems and Microsoft Office applications.

Responsibilities

• Serve as primary contact for patients after diagnosis, communicating results and education.
• Coordinate follow-up care and schedule procedures or appointments.
• Educate patients on treatment plans and next steps.
• Document patient interactions accurately in the EMR.
• Submit prior authorizations for medications and monitor approvals.
• Maintain authorization documentation and renewals, and handle appeals as needed.
• Collaborate with providers, pharmacies, and insurers to ensure access to treatment.

Skills

Medical terminology

Communication

Organization

Customer service

multitask management

EMR experience

Microsoft Office

Education

Medical Assistant certification or equivalent

Tools

EMR systems

Microsoft Office

Job description

Description

Job Summary

The Treatment & Authorization Representative serves as the primary point of contact for patients following diagnosis by communicating pathology results, educating patients on provider-recommended treatment plans, coordinating follow-up care, and obtaining insurance authorizations for prescribed medications and treatments. This position works closely with providers, patients, pharmacies, and insurance carriers to ensure timely access to treatment while delivering compassionate patient care, exceptional customer service, and accurate clinical documentation.

Primary Responsibilities

Patient Treatment Communication

• Contact patients with pathology test results and communicate both normal and abnormal findings with professionalism and compassion.
• Explain provider-recommended treatment plans and answer patient questions within scope.
• Schedule procedures, surgeries, follow-up appointments, or additional treatment as directed by providers.
• Provide education regarding medications, procedures, and next steps in the patient's treatment plan.
• Document all patient interactions accurately in the electronic medical record (EMR).

Prior Authorizations & Insurance

• Process prescription prior authorizations for medications, including biologic therapies and specialty medications.
• Submit clinical documentation and medical necessity information to insurance carriers.
• Monitor authorization requests and follow up to ensure timely approvals.
• Review denials and complete appeals as requested by providers.
• Maintain accurate authorization documentation, approval dates, expiration dates, and authorization numbers.
• Proactively renew authorizations to prevent interruptions in patient treatment.

Patient Care & Collaboration

• Serve as a liaison between patients, providers, pharmacies, and insurance companies.
• Maintain knowledge of dermatology treatments, pathology terminology, and insurance authorization requirements.
• Communicate professionally with internal departments to coordinate patient care.
• Deliver outstanding customer service while maintaining empathy and professionalism during sensitive conversations.
• Ensure compliance with HIPAA, OSHA, and organizational policies.
• Perform other duties as assigned.

Qualifications

Education & Experience

• Medical Assistant certification or equivalent clinical experience preferred.
• Dermatology experience strongly preferred.
• Prior authorization experience preferred; biologics experience is a plus.
• Strong understanding of medical terminology.
• Excellent communication, organization, and customer service skills.
• Ability to multitask and prioritize in a fast-paced environment.
• Experience with EMR systems and Microsoft Office applications.

Working Hours:

Monday- Thursday (or) Tuesday- Friday: 8:00 - 5:00

* in person Monday through Thursday or Tuesday through Friday and one work from home day five days a week