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Surgical Prior Representative and Support at Waccamaw Dermatology, LLC

Myrtle Beach, South Carolina, United States -

Full Time

Start Date

Immediate

Expiry Date

02 Jun, 26

Salary

0.0

Posted On

04 Mar, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Prior Authorization, Insurance Verification, Clinical Documentation, EMR, CPT Coding, ICD-10 Coding, HIPAA Compliance, Scheduling, Communication, Organizational Skills, Detail Oriented, Follow-up, Multitasking

Industry

Medical Practices

Description

Description Position Summary: The Surgery Prior Authorization Specialists is responsible for obtaining and managing prior authorizations for Mohs surgical procedures to ensure timely approval and reimbursement. This role supports clinical and administrative operations by coordinating with insurance carriers, patients, providers, and referring offices. The position also includes various administrative support duties to support the surgical team and office flow. Key Responsibilities: * Obtain prior authorizations for surgical procedures * Verify patient insurance eligibility, benefits, and coverage * Submit required clinical documentation to insurance companies and follow up on approval status * Communicate with appropriate staff authorization status and document in the patient's chart accordingly * Create new patient charts ensuring all required documents are obtained and scanned in patient's chart properly * Enter and update patient's insurance accurately into the practice management system * Request and maintain medical records from referring offices to ensure receipt of required documents * Assist with scheduling when needed * Maintain confidentiality in accordance with HIPPA guidelines * Provide general administrative support to the surgical team * Perform all other support duties as assigned Qualifications: * High school diploma or equivalent required * Minimum of 2 - 3 years of prior authorization experience, preferably in a surgical or specialty setting * Knowledge of Insurance plans, CPT/ICD-10 coding, and authorization process * Experience with EMR * Strong organizational skills and detail oriented * Excellent communication and follow-up skills * Ability to multitask in a fast-paced environment * Self-motivated and ability to work independently

Responsibilities

The specialist is responsible for obtaining and managing prior authorizations for Mohs surgical procedures to ensure timely approval and reimbursement, while also supporting clinical and administrative operations by coordinating with various external parties.