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!

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 AuthorizationSpecialist 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 revenue, 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.

Apply Today! Be a part of a dynamic team that’s transforming skin health. We can't wait to meet you!

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