Surgical Prior Representative and Support

Waccamaw Dermatology, LLC•Myrtle Beach, SC

just now

About The Position

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.

Requirements

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

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