Prior Authorization Coordinator

About the role

The organization operates within the dermatology field, offering medical, surgical, and aesthetic dermatology and dermatopathology services. It focuses on providing personalized care tailored to each patient's needs and priorities, aiming to make comprehensive dermatology services accessible within local communities and supporting both patients and primary care providers through effective communication and coordination. The PRIOR AUTHORIZATION COORDINATOR is responsible for managing the medication and procedure prior authorization process, including prescription refills. This role ensures timely approvals by coordinating with insurance companies, healthcare providers, and patients, contributing to smooth patient access to necessary dermatology treatments.

Responsibilities

• Interview patients to assist with obtaining authorizations for medications and procedures
• Process documentation to expedite approval and perform necessary follow-up
• Receive and monitor pre-authorization requests
• Obtain insurance authorizations via phone, fax, or online systems while maintaining confidentiality
• Verify accuracy and completeness of information and supporting documents
• Submit referrals and medical records to insurance carriers
• Manage correspondence with insurance companies, physicians, specialists, and patients
• Handle denials and submit appeals to secure approvals
• Document all prior authorization activities and update patient records accurately

Requirements

• High school diploma or GED required
• Certified Medical Assistant certificate preferred
• Certified and licensed pharmacy technician preferred
• Knowledge of online authorization systems and medical terminology
• Strong computer skills to manage clinical information
• Ability to track multiple in-process authorizations
• Effective interpersonal and customer service skills
• Ability to work independently with attention to detail
• Capacity to manage multiple tasks and adapt to change

Benefits

• Medical plans with HMO or PPO options
• Dental plan
• Healthcare Savings Account (HSA)
• 401(k) plan with generous match
• Employee Assistance Plan
• Additional voluntary benefits including short-term disability, accident, cancer indemnity, and life insurance through AFLAC

Pay

Salary ranges from USD 20.00 to 27.14 per hour depending on experience and other factors.