Join Our Team at Skin and Cancer Institute!

Are you passionate about dermatology and skin health? Do you thrive in a dynamic, patient-focused environment? Skin and Cancer Institute is looking for dedicated professionals to join our team!

Why Join Us?

At Skin and Cancer Institute, we are committed to excellence in dermatology, skin cancer treatment, and cosmetic procedures. We offer a supportive and collaborative work culture where your skills and dedication make a real impact.

Summary of Position

• Reports to: Prior Authorization Manager
• Work schedule: Monday to Friday (maximum of 40 hours per week)
• Work Category: Full-time, Remote

The Patient Access Team Lead provides leadership and operational oversight for insurance eligibility and benefits verification, referral coordination, and prior authorization functions. This position ensures accurate, timely, and compliant patient access workflows that support continuity of care, financial clearance, and prevention of avoidable authorization-, referral-, and eligibility-related denials.

The Patient Access Team Lead leads team performance across all three functions, manages workflow standards and escalations, coordinates cross-functional processes, and uses quality and productivity data to improve departmental performance. Success requires strong leadership, comprehensive payer knowledge, sound judgment, accuracy, and effective management of high-volume healthcare operations.

WHAT YOU'LL DO:

Department Leadership & Team Management

• Provide day-to-day leadership, direction, coaching, training, and performance support to Prior Authorization, Referrals, and Insurance Eligibility team members.
• Organize workloads and priorities based on appointment dates, urgency, payer requirements, staffing, and operational needs.
• Monitor team productivity, accuracy, turnaround times, documentation quality, service levels, and adherence to established workflows.
• Support onboarding and cross-training to maintain appropriate coverage across the three functional areas.
• Oversee eligibility and benefits verification, including active coverage, network status, cost-share information, coverage limitations, and payer requirements.

Prior Authorization, Referrals & Eligibility Oversight

• Oversee referral receipt, validation, processing, tracking, follow-up, and closure, including resolution of incomplete, expired, exhausted, or mismatched referrals.
• Oversee prior authorization and precertification workflows, including submission, tracking, renewals, additional-information requests, denial escalation, and closure.
• Ensure authorization approvals and referrals align with scheduled services, providers, locations, codes, units or visits, and effective dates, as applicable.
• Oversee financial-clearance workflows and ensure insurance-related barriers are identified and communicated promptly to appropriate teams.
• Serve as an escalation point for complex payer, eligibility, referral, and authorization issues that may affect timely patient access.

Patient Access & Financial Clearance

• Coordinate with patients, providers, payers, scheduling, clinical teams, billing, revenue cycle, and other departments to resolve access barriers.
• Ensure accurate and complete documentation of payer responses, authorization details, referral information, benefit findings, communications, and follow-up activities.
• Conduct or coordinate quality audits for accuracy, completeness, timeliness, and compliance with departmental standards.
• Review avoidable denials related to authorization, referral, eligibility, or documentation errors and implement corrective actions within the department’s control.
• Track recurring errors and trends and provide targeted coaching, education, and workflow improvements.

Quality, Documentation & Denial Prevention

• Manage work queues, tracking tools, reports, and daily priorities to ensure timely completion of departmental activities.
• Standardize handoffs among eligibility, referrals, prior authorization, scheduling, and related teams to reduce duplicate work and processing delays.
• Collaborate with internal departments to support coordinated patient access and resolve escalated operational issues.
• Communicate professionally with patients, referring providers, insurance representatives, and internal stakeholders regarding escalated matters.
• Ensure timely updates to patient demographics, subscriber information, insurance data, and apparent coordination-of-benefits indicators

Cross-Department Collaboration & Escalation Management

• Develop and reinforce departmental training on payer requirements, documentation standards, systems, workflows, and process changes.
• Ensure adherence to HIPAA, patient confidentiality requirements, payer policies, healthcare regulations, and organizational procedures.
• Stay current on payer policy changes, authorization and referral requirements, insurance regulations, and relevant industry developments.
• Monitor departmental KPIs and operational reports to identify workload concerns, quality issues, denial trends, and improvement opportunities.
• Support organizational growth, acquisitions, departmental integration, and special projects as assigned.

Compliance, Reporting & Continuous Improvement

• Perform other duties as assigned.

WHAT WE'RE LOOKING FOR

Required Skills / Abilities:

• Strong leadership, coaching, team-development, and performance-management skills.

• Comprehensive knowledge of prior authorization, referral management, insurance eligibility, benefits verification, patient access, and revenue cycle workflows.
• Excellent customer service and interpersonal communication skills.
• Strong analytical and problem-solving abilities.
• Exceptional attention to detail and data-entry accuracy.
• Ability to prioritize and manage multiple tasks in a fast-paced environment.
• Strong organizational and time management skills.
• Ability to maintain confidentiality and professionalism at all times.
• Proficiency in Microsoft 365 applications, including Outlook, Excel, Word, and Teams.
• Working knowledge of EMR and practice management systems.
• Ability to interpret insurance plans, payer policies, medical documentation, authorization requirements, referral requirements, and coverage rules.
• Ability to work independently and collaboratively within a team environment.

Education & Experience

Required:

• High School Diploma or equivalent. 
• Minimum of 4 years of healthcare experience involving prior authorization, referrals, insurance eligibility, benefits verification, patient access, medical billing, revenue cycle, or related healthcare operations, including prior supervisory, team lead, or management experience. 
• Experience using payer websites, portals, clearinghouses, and electronic eligibility tools. 
• Basic knowledge of medical terminology and healthcare operations. 

Preferred:

• Associate's degree in healthcare administration, Business Administration, or related field.
• 5+ years of relevant patient access, prior authorization, referral, eligibility, or revenue cycle experience within a multi-specialty medical practice.
• Experience in dermatology, oncology, surgical, or specialty healthcare environments.
• Experience with Modernizing Medicine (EMA), ModMed, or similar EMR systems.
• Certified Revenue Cycle Representative (CRCR) or relevant healthcare certification.
• Experience in remote healthcare operations. 

Equipment & Software Operation

The incumbent in this position may operate any/all of the following equipment:

• Microsoft Outlook, Word, Excel, PowerPoint, fax, email, phone, Microsoft Teams, Zoom Call Center, EMA, Klara and Next Patient

WHAT WE OFFER

Placement within the range will be based on objective, job-related factors, which may include relevant experience, education, training, skills, certifications, internal equity, and business considerations

• Competitive salary
• Night shift differential pay
• Statutory benefits
• Paid time off
• Professional development opportunities
• Supportive and fair work environment

Apply Today! Be a part of a dynamic team that’s transforming skin health. We can't wait to meet you!

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