Job Description

WHO WE ARE

At Skin and Cancer Institute, we believe in more than just jobs; we believe in fostering careers that resonate with excellence, compassion, and innovation. 

Discover a workplace that facilitates growth, celebrates collaboration, and propels your professional journey forward.

Skin and Cancer Institute’s commitment to excellence isn’t just skin-deep – it permeates every aspect of our work. We understand that true impact requires a passion that goes beyond the surface. Here, we believe in nurturing a genuine devotion to dermatology, where every team member is driven by a shared enthusiasm for improving lives through advanced skincare solutions.

Our patients deserve the very best, and it starts with your desire to be of service to others. Your deep-rooted commitment ensures that each individual receives personalized, empathetic care beyond medical treatment.

SUMMARY OF POSITION   

This position manages and oversees the overall policies, objectives , and initiatives of an organization's revenue cycle activities to optimize the patient financial interaction along the care continuum . The Prior Authorization Specialist partners with patients and providers regarding authorization requests and updates to patient records , oversees prior authorization department including extended department vendors , and implements best practices to maximize r evenue, all with a focus on process, communication , and team effort.   

ESSENTIAL DUTIES  

• 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 internal and extended business office staff. 
• 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 medications. 
• 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.

SKILLS/QUALIFICATIONS/EXPERIENCE  

• 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. 
• 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.
• Must have excellent written and verbal communication skills.  
• Able to work with a diverse group of people.  
• Must be able to work in a fast-paced office environment.  
• Other duties as assigned.  

POSITION REQUIREMENTS  

To perform effectively in this position, the incumbent must have:  

• Associate degree highly preferred. 
• 5+ years of related experience required. 
• Proficiency in Microsoft Office with advanced Excel skills. 
• Experience with Intacct, ConnectWise, Ubersmith, System Integration and M&A a plus. 
• Strong communication skills, written and verbal. 
• Ability to work independently and manage time appropriately. 

Are you ready? Your next chapter begins here – where opportunities are not just openings; they are gateways to a fulfilling and impactful career. Embark on a career journey where innovation, compassion, and expertise converge. The Skin and Cancer Institute is looking for caring and compassionate individuals to join our dynamic team. If you’re ready to make a meaningful impact and be a part of meaningful dermatological care, explore our current openings below.

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