Riverchase Dermatology, an AQUA Dermatology portfolio practice, is Florida’s largest and most comprehensive full-service skin care provider in the Southeast, offering medical, surgical, and cosmetic dermatology, plastic surgery, vein care, and radiation oncology. Founded in 1998, AQUA Dermatology is the Southeast’s premier dermatology practice with over 100 locations throughout Alabama, Florida, and Georgia. Our established practices and experienced physicians offer patients the most quality outcomes and an exceptional patient experience. From common rashes to skin cancer treatments, and plastic surgery procedures to an array of vein treatments, no case is beyond our experience and expertise.

We are seeking an Authorization Team Lead who provides support for verifying current and accurate patient insurance information and works with insurance companies to obtain authorization (s) for services. The Lead Authorizations Specialist will mentor the team through monitoring and auditing work while adhering to RCD Policy & Procedures.

ESSENTIAL FUNCTIONS

• Trains, coaches, and leads the authorization team; monitors and evaluates work; and reports any issues to the manager.
• Verify patient benefits and calculate out-of-pocket costs using multiple insurance resources.
• Obtain, review, and input insurance authorization and referrals before patient services.
• Monitor and track patient authorizations
• Be proficient in the use of ICD-10 and CPT codes.
• Verifies the status of participating providers and insurance plans.
• Supports medical office team members.
• Works closely with the management team in the business office to ensure all internal and external customer service
• issues are addressed.
• Participates in educational activities and leads/attends team staff meetings
• Maintains insurance company reference materials
• Analysis of pre-determination of benefit estimates vs actual
• Surgery collection & authorization review
• Coordinates the authorization team work schedules and effectively manages time-off requests ensuring adequate coverage at all times.
• Review/update/approve time cards in the timekeeping system for the authorization team
• Performs other duties as required and takes on additional special projects as assigned.

We offer competitive salaries and benefits:

Medical, Dental, and Vision available after 30 days of hire

Short-term disability and life insurance, and many ancillary options.

401k available after 90 days of hire

Excellent growth and advancement opportunities

Discounts on employee products and services

POSITION TYPE AND EXPECTED HOURS OF WORK

Full-Time

Monday – Friday

8 am - 5 pm, Hybrid schedule available upon the completion of on-site training

TRAVEL
Travel is not expected for this position.

SUPERVISORY RESPONSIBILITY

This position holds no formal supervisory authority; however, the Lead Authorization Specialist does serve as a coach and mentor to authorization specialist staff

QUALIFICATIONS

Education - Associate's Degree preferred or high school graduate, GED/equivalent. Certificate from a technical school for

billing a plus

Experience – Medical office experience; dermatology and plastic surgery preferred. Knowledge of HIPAA regulations, insurance payers, ICD-10 and CPT codes, and fee schedule reimbursement methodology. 3 years of experience in a medical office or central billing office performing revenue cycle functions

Communication – Excellent verbal and written communication skills.

Work Style - Must be able to work well independently but ask for help when needed. Ability to analyze and interpret information, ability to interact and decipher information telephonically and electronically.