Insurance Coordinator
Raleigh Plastic Surgery Center | Raleigh, NC
About Us
Raleigh Plastic Surgery Center is a leading provider of cosmetic and reconstructive surgical care in the Raleigh area. We're committed to delivering exceptional patient experiences from consultation through recovery, and we're looking for a detail-oriented Insurance Coordinator to join our administrative team.
Position Summary
The Insurance Coordinator serves as the primary liaison between patients, surgeons, and insurance carriers, ensuring accurate and timely processing of insurance verifications, pre-authorizations, and claims related to reconstructive and medically necessary procedures. This role is essential to maintaining smooth practice operations and a positive patient financial experience.
Key Responsibilities
- Verify patient insurance benefits and eligibility prior to scheduled procedures
- Obtain pre-authorizations and pre-certifications for reconstructive and medically necessary surgeries
- Communicate with insurance companies to resolve coverage questions, denials, and appeals
- Coordinate with surgeons and clinical staff to gather documentation needed for prior authorization requests
- Explain insurance coverage, out-of-pocket costs, and payment responsibilities to patients and collect payments
- Maintain accurate records of authorizations, claims status, and patient communications in the practice management system
- Stay current on payer policies, CPT/ICD-10 coding requirements, and prior authorization criteria relevant to plastic and reconstructive surgery
- Collaborate with billing staff to ensure accurate claim submission and reimbursement
- Assist patients with appeals for denied claims when medically necessary procedures are involved
Qualifications
- High school diploma or equivalent required; associate degree or relevant certification preferred
- 2+ years of experience in medical insurance verification, prior authorization, or medical billing (plastic surgery, dermatology, or surgical specialty experience strongly preferred)
- Working knowledge of CPT, ICD-10, and HCPCS coding
- Familiarity with major insurance carriers and their authorization processes
- Excellent communication and interpersonal skills, with the ability to explain complex insurance information to patients clearly and compassionately
- Strong organizational skills and attention to detail
- Proficiency with electronic health records (EHR) and practice management software
- Ability to multitask in a fast-paced clinical office environment
What We Offer
- Competitive salary based on experience
- Health and dental insurance
- Paid time off and holidays
- 401(k) with employer match
- Employee discounts on cosmetic services
- Supportive, team-oriented work environment
Raleigh Plastic Surgery Center is an equal opportunity employer.
