Dermatology Prior Authorization Coordinator

4 weeks ago

Mason, United States DOCS Dermatology Full time
Job Title: Prior Authorization Specialist

At DOCS Dermatology, we are seeking a highly skilled Prior Authorization Specialist to join our team. This role plays a vital part in ensuring the efficiency and accuracy of our billing process, directly impacting our patients and resulting in a positive patient experience.

Key Responsibilities:
  • Streamline and secure pre-certification, medical authorization, and referral processes, ensuring compliance with insurance requirements.
  • Coordinate with insurance entities, review boards/organizations, and clinical contacts for effective communication and benefit determination.
  • Establish positive rapport with employees, patients, physicians, and vendors utilizing written and verbal communication methods.
  • Facilitate peer-to-peer reviews for escalated encounters and address inquiries from providers, staff, and patients.
  • Ensure timely and accurate insurance authorizations and conduct medical benefits investigations.
  • Monitor schedules for insurance coverage changes, oversee specialty pharmacy orders, and maintain/update the ordering spreadsheet.
  • Initiate patient education on available assistance programs.
  • Document information, responses, and status updates/changes in Electronic Medical Record (EMR) system.
Requirements:
  • High school diploma or equivalent.
  • 1-2 years of relevant experience in medical billing and/or prior authorization within a healthcare practice.
  • Knowledge of Medicare/Medicaid and major insurance carrier's guidelines.
  • Working knowledge of ICD-9-10 medical coding and billing and medical terminology.
Physical Demands:

The employee is required to frequently sit, stand, walk, talk, hear, and use devices including but not limited to computers, phones, and iPads. Regularly use close vision and ability to adjust focus. Occasionally stoop, bend, reach above shoulders, push/pull doors and drawers, and lift up to 25 pounds.

DOCS Dermatology is an Equal Opportunity Employer and welcomes applications from diverse candidates.

  • IT Project Manager

    3 weeks ago

    Mason, United States DOCS Dermatology Full time

    About the RoleCincinnati-based DOCS Dermatology is seeking an experienced IT Project Manager to join our team. As a key member of our IT department, you will be responsible for coordinating internal and external resources to ensure projects are completed on time, within budget, and to the highest standards.Key ResponsibilitiesDevelop and maintain project...

  • IT Project Manager

    5 days ago

    Mason, United States DOCS Dermatology Full time

    Job Title: IT Project ManagerCincinnati Based PositionAt DOCS Dermatology, we are seeking an experienced IT Project Manager to join our team. As a key member of our IT department, you will be responsible for leading projects that align with our organizational goals and objectives.Job Responsibilities:Ensure all aspects of a project are organized and in...

  • IT Project Manager

    2 weeks ago

    Mason, United States DOCS Dermatology Full time

    Job Title: IT Project ManagerCincinnati-based position at Dermatologists of Central States (DOCS), one of the largest and most established dermatology practices in the nation.About DOCSWith over 225 providers across 95+ locations in 7 states, DOCS has been serving patients for over 40 years. Our mission is to put the patient first, providing easy access to...

  • Patient Services Coordinator

    2 days ago

    Mason, Ohio, United States PhyNet Dermatology LLC Full time

    Patient Services RepresentativeWe are seeking a highly skilled Patient Services Representative to join our team at PhyNet Dermatology LLC. As a key member of our call center, you will play a vital role in providing exceptional support to our dermatologists and patients.Key Responsibilities:Answer incoming calls and address patients' scheduling needs or...

  • Dermatology Physician

    2 days ago

    Mason, United States Addison Kenway. Full time

    Mason, OH Dermatologist Job#16481353 Dermatology Physician Job Opportunity in Southwestern Ohio - Just North of Cincinnati Excellent opportunity for a Dermatologist who would be open to leading a new clinic. This position affords you the ability to practice with clinical autonomy and guide the development of the practice - be the leader without the...

  • Dermatology Physician Opportunity

    3 weeks ago

    Mason, United States Addison Kenway. Full time

    Join Addison Kenway as a Clinical Leader in DermatologyWe are seeking a highly skilled and experienced Dermatologist to lead our new clinic in Mason, OH. As a Clinical Director, you will have the opportunity to practice with clinical autonomy and guide the development of the practice.Key Responsibilities:Lead and manage a team of healthcare...

  • Patient Services Coordinator

    2 weeks ago

    Mason, Ohio, United States PhyNet Dermatology LLC Full time

    Job SummaryWe are seeking a highly skilled Patient Services Representative to join our team at PhyNet Dermatology LLC. As a key member of our healthcare team, you will play a vital role in ensuring that our patients receive exceptional care and service across multiple practices and facilities.Key Responsibilities:Patient Interaction: Welcome patients warmly...

  • Patient Services Coordinator

    4 weeks ago

    Mason, Ohio, United States PhyNet Dermatology LLC Full time

    Job SummaryPhyNet Dermatology LLC is seeking a highly skilled Patient Services Representative to join our team. As a Patient Services Representative, you will play a pivotal role in ensuring that our patients receive exceptional care and service across multiple practices and facilities.Key Responsibilities:Patient Interaction: Welcome patients warmly and...

  • Cafe Event Coordinator

    3 weeks ago

    Mason, Ohio, United States Fooda Full time

    Job OverviewWe are seeking a highly motivated and organized Event Coordinator to join our team at Fooda. As an Event Coordinator, you will play a critical role in supporting our events and ensuring a seamless experience for our customers.Key Responsibilities:Support events in various capacities, including setup, teardown, and problem-solvingGain proficiency...

  • Business Operations Coordinator

    4 weeks ago

    Mason, Ohio, United States Omya Full time

    Job Summary:We are seeking a highly organized and detail-oriented Business Operations Coordinator to join our team at Omya. As a key member of our customer service department, you will provide critical support to our team, ensuring seamless day-to-day operations and contributing to our company's success.Key Responsibilities:Maintain a Safe and Healthy Work...

  • Administrative Assistant

    12 hours ago

    Mason, United States Russell Tobin Full time

    Russell Tobin's client is hiring for UM Support Analyst in Mason, OH.Job Title: UM Support AnalystLocation: Mason, OH (100% Onsite)Schedule: 8:30 AM – 5:30 PM (Flexible)Pay Rate: $19 - $21.43 per hourGeneral Function:The UM Support Analyst will perform administrative and data entry tasks in support of Utilization Management (UM) prior authorization...

  • Administrative Assistant

    2 days ago

    Mason, United States Russell Tobin Full time

    Russell Tobin's client is hiring for UM Support Analyst in Mason, OH.Job Title: UM Support AnalystLocation: Mason, OH (100% Onsite)Schedule: 8:30 AM – 5:30 PM (Flexible)Pay Rate: $19 - $21.43 per hourGeneral Function:The UM Support Analyst will perform administrative and data entry tasks in support of Utilization Management (UM) prior authorization...

  • Utilization Management Support Assistant

    4 days ago

    Mason, United States Bernard Nickels & Associates Full time

    Type: ContractDuration: 6 Months (w/ potential for extension)Location: Mason, OHWork Schedule: Monday-Friday, 8:30/9am–5/5:30pm ESTPay Range: $17 to $20 per hourJob Summary: The Utilization Management (UM) Support Assistant will play a critical role in supporting our leading vision care client's upcoming "Go Live" for Kansas, Florida, and Michigan,...

  • Utilization Management Support Assistant

    4 days ago

    Mason, United States Bernard Nickels & Associates Full time

    Type: ContractDuration: 6 Months (w/ potential for extension)Location: Mason, OHWork Schedule: Monday-Friday, 8:30/9am–5/5:30pm ESTPay Range: $17 to $20 per hourJob Summary: The Utilization Management (UM) Support Assistant will play a critical role in supporting our leading vision care client's upcoming "Go Live" for Kansas, Florida, and Michigan,...

  • Ophthalmology Specialist

    3 weeks ago

    Mason, United States Global Channel Management Full time

    Ophthalmologist Consultant RoleGlobal Channel Management seeks a licensed Ophthalmologist to review prior authorizations requests and determine whether to approve or deny a request based on medical information provided by the ordering provider within specified timeframes.Key Responsibilities:Review clinical and billing guidelines regarding high-cost and...

  • Pharmacy Technician I

    2 weeks ago

    Mason, Ohio, United States Elevance Health Full time

    Pharmacy Technician I Job DescriptionAt Elevance Health, we are seeking a highly skilled Pharmacy Technician I to join our team. As a Pharmacy Technician I, you will play a vital role in ensuring the smooth operation of our pharmacy services.Key Responsibilities:Verify member information and input data for pharmacists.Educate members on pharmacy-based rules...

  • Logistics Coordinator

    4 weeks ago

    Mason, Ohio, United States PetroChoice Full time

    Job SummaryPetroChoice, a leading distributor of lubricants and services, is seeking a skilled Delivery Driver to join our team at our Mason, Ohio facility. As a key member of our logistics team, you will be responsible for transporting deliveries in a safe and responsible manner, ensuring timely and accurate delivery of products to our customers.Key...

  • Healthcare Customer Support Specialist

    1 month ago

    Mason, Ohio, United States EVERSANA Company Full time

    About the RoleWe are seeking a highly skilled and compassionate Healthcare Call Center Specialist to join our team at EVERSANA Company. As a key member of our patient services support center, you will provide dedicated support to patients and healthcare providers, ensuring seamless communication and resolution of benefit coverage, payments, and...

  • Patient Services Specialist

    1 month ago

    Mason, Ohio, United States EVERSANA Company Full time

    About the RoleWe are seeking a highly skilled and compassionate Healthcare Call Center Specialist to join our team at EVERSANA Company. As a key member of our patient services support center, you will provide dedicated support to patients and healthcare providers, ensuring seamless communication and resolution of benefit coverage, payments, and...

  • Program Specialist II

    2 weeks ago

    Mason, United States EVERSANA Full time

    Job DescriptionEversana is a global leader in commercialization services for the life sciences industry. We are seeking a highly skilled Program Specialist II to join our team.Job Summary:The Program Specialist II will provide dedicated support to patients and healthcare providers for activities related to benefit coverage, payments, and reimbursements. This...