Are you caring and friendly? Are you the "go-to" problem solver?

Consider joining the largest and fastest-growing dermatology group practice, that will recognize your hard work and value!

Schweiger Dermatology Group, a leader in the field of dermatology practice with multiple locations throughout New York, New Jersey, and Pennsylvania is searching for an experienced Prior Authorization Supervisor to join our corporate office in Long Island City, NY.

Prior Authorization Supervisor

A prior authorization supervisor is responsible for supporting a team of prior authorization specialists who work to ensure that medical services, medications, procedures, and treatments are approved by insurance companies before they are provided to patients.

Essential Functions and Responsibilities

• Supervise a team of prior authorization/referral specialists, including training, and evaluating their performance.
• Facilitate the creation and maintenance of policies and procedures related to the prior authorization & referral process' to ensure all requests are handled efficiently and accurately.
• Ensure all requests for prior authorization/referrals are processed within established timelines and guidelines.
• Review requests for prior authorization/referrals that require additional review, such as those that are complex or high cost.
• Act as the lead for all Horizon NJ Health (government plan) prior authorization claims
• Coordinate with healthcare providers and insurance companies to obtain necessary approvals for medical services, procedures, and treatments.
• Monitor the accuracy and completeness of all prior authorization requests and ensure they comply with relevant regulations and policies.
• Identify opportunities to improve the prior authorization/referral process, including streamlining workflows and implementing new technologies or tools.
• Communicate with patients, healthcare providers, and insurance companies about the status of prior authorization and referral requests.
• Generate reports and analytics related to the prior authorization and referral process' to evaluate performance and identify areas for improvement.
• Maintain up-to-date knowledge of relevant regulations, policies, and guidelines related to the prior authorization process.
• Other duties as assigned by supervisor on an as needed basis.

Qualifications

• 2-5 years of previous work experience working on Prior Authorizations required.
• Previous working knowledge and experience with Modmed preferred.
• Working knowledge and application of HIPAA & OSHA compliance

Travel

This is a remote position; therefore, employee is not required to attend monthly in office cadence. From time to time, person may be required to attend in-person team meetings.

Schweiger Dermatology Group, is an equal opportunity employer and does not discriminate in its hiring process with applicants, whether internal or external, because of race, creed, color, age, national origin, ancestry, religion, gender, sexual orientation, gender identity, disability, genetic information, veteran status, military status, application for military service or any other class per local, state or federal law.