Surgical Care Navigator

KP Plastic Surgery is a patient-centered plastic surgery group serving patients throughout Los Angeles and surrounding communities. Our team is committed to providing thoughtful, safe, ethical, and individualized care throughout every stage of the patient journey—from the initial inquiry and consultation through insurance coordination, surgical planning, recovery, and follow-up. We value professionalism, compassion, confidentiality, accuracy, teamwork, and respect for each patient’s individual goals. We are seeking a highly organized and personable Surgical Care Navigator to help patients understand and move through the surgical journey while supporting clinical operations, payer coordination, scheduling, and approved practice-growth activities. Position Summary The Surgical Care Navigator is a cross-functional position combining patient reception, medical-assistant support, surgery scheduling, insurance coordination, prior authorization, letters of agreement, payer communication, patient follow-up, and approved marketing and outreach. The successful candidate will serve as a knowledgeable and compassionate point of contact for patients from their first inquiry through consultation, surgical planning, insurance coordination, surgery, and postoperative follow-up. This position does not independently diagnose, prescribe, determine medical necessity, select surgical treatment, provide medical advice, or perform duties reserved for licensed healthcare professionals. Employment Structure This is a part-time position with a variable schedule based on patient volume, clinic operations, outreach needs, and mutually agreed availability. The schedule may increase or decrease as practice needs evolve. Excellent opportunity to transition to a full-time role in the near future. All time worked must be accurately recorded and paid. The employee will remain eligible for all legally required protections applicable to non-exempt California employees. Essential Responsibilities: Patient Care and Front-Office Support Welcome patients and visitors in a professional, warm, and respectful manner. Answer phones and respond to approved electronic inquiries. Schedule consultations, procedures, surgeries, and follow-up appointments. Register patients and verify demographic, insurance, and contact information. Coordinate check-in, check-out, forms, deposits, payments, and patient communications. Explain administrative processes, next steps, office policies, and scheduling requirements. Follow up with prospective and established patients in a timely manner. Escalate complaints, urgent concerns, clinical questions, and safety issues to the appropriate supervisor or licensed provider. Perform only those medical-assistant duties expressly permitted by California law and practice policy, after required training and demonstration of competency, and under the level of supervision required by law. Provider delegation does not authorize performance of any duty outside the lawful scope of a California medical assistant. Prepare examination and procedure rooms. Maintain supplies, equipment, and room readiness. Obtain and document vital signs and approved intake information. Assist providers during examinations and procedures as directed. Review standardized written or electronic patient education and provider-approved instructions without independently interpreting, modifying, supplementing, or providing clinical advice regarding those instructions. Document accurately in the electronic health record. Follow infection-control, OSHA, privacy, safety, and quality procedures. Never independently diagnose, prescribe, determine medical necessity, triage beyond approved protocols, or alter a provider’s clinical plan. Surgical Scheduling and Navigation Coordinate consultations, preoperative appointments, medical clearances, laboratory testing, imaging, surgery dates, facility arrangements, and postoperative visits. Maintain accurate surgical calendars and communicate schedule changes promptly. Confirm that required consents, forms, deposits, clearances, and documentation are complete before surgery. Coordinate non-clinical logistics with surgeons, anesthesiologists, facilities, vendors, and patients. Track cancellations, rescheduling, no-shows, outstanding requirements, and postoperative follow-up. Help patients understand the administrative steps involved in preparing for surgery without providing independent medical advice. Protect patient confidentiality during all communications. Insurance and Prior Authorization Verify benefits, eligibility, exclusions, deductibles, coinsurance, authorization requirements, network status, and payer-specific documentation requirements. Prepare and submit prior-authorization requests using accurate information supplied or approved by the provider. Track authorization status, deadlines, peer-to-peer requirements, appeals, denials, and requests for additional documentation. Coordinate with providers to obtain complete and accurate clinical records. Communicate payer requirements and status updates to patients without guaranteeing coverage or reimbursement. Maintain organized records of submissions, payer communications, determinations, appeals, and deadlines. Escalate unusual, disputed, high-dollar, legal, or precedent-setting payer matters to authorized management. Letters of Agreement and Payer Negotiations Assist with letters of agreement and one-off payer negotiations only under approved practice procedures and delegated authority. Prepare accurate documentation for review by authorized management. Communicate professionally with insurance companies, facilities, and other authorized representatives. Never misrepresent diagnoses, medical necessity, services, provider status, network status, patient circumstances, or expected coverage. Never promise authorization, payment, reimbursement, or a specific patient financial responsibility. Obtain management approval before accepting or communicating final negotiated terms. Document all negotiations, approvals, payer instructions, and contractual requirements. Marketing, Outreach, and Patient Growth Respond promptly and professionally to approved prospective-patient inquiries. Explain practice services using only approved materials, scripts, pricing, and claims. Assist prospective patients with the consultation and scheduling process. Track qualified inquiries, attended consultations, scheduled surgeries, completed cases, and referral sources. Support approved outreach to physicians, referral sources, community organizations, and professional contacts. Assist with approved educational events, campaigns, website content, social-media content, and patient communications. Obtain required permission before using patient photographs, testimonials, reviews, stories, or protected information. Use only truthful, approved, and substantiated marketing claims. Do not guarantee results, safety, recovery time, insurance coverage, eligibility, or surgical outcomes. Do not use pressure tactics, discriminatory language, misleading claims, unapproved discounts, or unapproved patient incentives. Submit marketing materials for required review before publication. Compensation and Performance Incentive Plan The base wage is $32 per hour . The employee may participate in a separate written performance incentive plan with a maximum incentive opportunity of $1,000 per month and $12,000 per calendar year . Any incentive will be compensation for bona fide administrative, patient-service, scheduling, authorization, coordination, outreach, and operational responsibilities actually performed by the employee. The incentive will not be calculated by the number or value of patient referrals, consultations, surgeries, procedures, payer mix, federal-program business, or a patient’s decision to undergo surgery. The incentive will not be paid for recommending a particular procedure, influencing medical necessity, steering a patient to KP Plastic Surgery, selecting a facility or provider, arranging federally reimbursable services, or generating referrals. Performance measures may include documented completion, timeliness, accuracy, patient-service quality, scheduling performance, authorization follow-through, payer documentation, compliance, outreach activity, and other nonclinical operational metrics established in advance by KP Plastic Surgery. The incentive plan will be in writing and will define the performance period, measurement methodology, eligibility requirements, calculation method, payment timing, treatment of refunds and adjustments, and treatment upon separation from employment. The incentive plan must be administered consistently with federal and California law, payer contracts, KP Plastic Surgery policies, and applicable anti-kickback, referral-fee, wage-and-hour, and professional-practice requirements. KP Plastic Surgery may revise or suspend the incentive plan prospectively as necessary to maintain legal compliance, subject to applicable wage requirements and the written plan. Qualifications High school diploma or equivalent. Medical Assistant certification preferred. Prior experience in a medical office, plastic surgery, dermatology, surgical scheduling, prior authorization, payer relations, or patient coordination preferred. Knowledge of electronic health records, scheduling systems, insurance portals, and office communications. Strong organizational skills and attention to detail. Excellent written, verbal, and interpersonal communication skills. Ability to manage multiple priorities in a growing practice. Ability to handle confidential information appropriately. Ability to work independently while collaborating with providers and administrative leadership. Bilingual English/Spanish or another relevant language preferred but not required. Ability to work in Los Angeles and meet applicable employment, occupational-health, and workplace requirements. Core Competencies Compassionate patient communication Professionalism and discretion Organization and follow-through Scheduling accuracy Insurance and payer persistence Ethical judgment Patient-centered consultation and service communication Teamwork and adaptability Accountability Respect for clinical boundaries Compliance Expectations All duties must be performed in compliance with applicable federal, California, and local requirements, including privacy and security requirements, wage-and-hour laws, professional-scope limitations, payer requirements, truth-in-advertising requirements, patient-consent requirements, OSHA requirements, infection-control standards, and KP Plastic Surgery policies. Employees must promptly report suspected privacy breaches, inaccurate payer submissions, patient-safety concerns, misleading advertising, harassment, discrimination, retaliation, or other compliance concerns. Physical and Work Environment Requirements Ability to work in a medical-office environment, with or without reasonable accommodation. Ability to sit, stand, walk, bend, reach, and use standard office and clinical equipment, with or without reasonable accommodation. Ability to lift or move supplies within reasonable workplace limits, with or without reasonable accommodation. Ability to maintain composure and professionalism in a busy patient-care setting, with or without reasonable accommodation. Ability to work occasional evenings, weekends, outreach events, or schedule variations as mutually agreed and operationally required, with or without reasonable accommodation. KP Plastic Surgery is committed to providing equal employment opportunities and maintaining a workplace free from unlawful discrimination, harassment, and retaliation. Employment decisions are made based on qualifications, performance, business needs, and applicable law. This job description describes the general nature and level of work expected. It is not an employment contract and does not alter California’s at-will employment relationship. KP Plastic Surgery may modify duties, reporting relationships, schedules, or requirements as permitted by law and business necessity. Pay: From $32.00 per hour Expected hours: 20.0 – 30.0 per week Work Location: Hybrid remote in Beverly Hills, CA 90211 The pay range for this role is: 32 - 38.25 USD per hour (Clinic - Beverly Hills) #J-18808-Ljbffr KP Plastic Surgery PC