Authorization Specialist

2 weeks ago


San Antonio, United States SPORTS MEDICINE ASSOCIATES OF SAN ANTONIO Full time

Seeking immediate hire to join our Business Office as an Authorization Specialist in a high-profile Sports Medicine Group supporting 18 physicians and 7 clinic locations.

DUTIES INCLUDE, BUT ARE NOT LIMITED TO:

    • Interpret insurance benefits and calculate patient responsibility
    • Review chart documentation to ensure patient meets medical policy guidelines
    • Prioritize incoming authorization requests according to urgency
    • Obtain authorizations via payer portals or by phone and follow up regularly on pending cases
    • Initiate appeals for denied authorizations
    • Respond to clinic questions regarding payer medical policy guidelines
    • Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order
    • Contact patients to discuss authorization status
    • Other duties as assigned
Qualifications:
  • Knowledge of commercial and governmental insurance plans (HMO, PPO, EPO, etc.) and payer portals
  • Knowledge of NextGen EHR software (preferred)
  • MS Office, basic office support skills (telephone, filing, data entry) and basic math skills.
  • Excellent telephone etiquette, pleasant personality and customer service skills.
  • Ability to multitask and remain focused while managing a high-volume, time-sensitive workload
  • Plans and prioritizes to meet deadlines
EXPERIENCE: Previous experience in a similar role required.
  • 3-4 years medical prior authorization and verification experience required
  • 2 years' experience in a medical related field preferred
High school diploma or GED required

Job Type: Full-time - Monday through Friday with a few rotating Saturday mornings. Traveling involved from one clinic to another based on schedule. Dependable transportation required.

Great benefits: Medical, Dental, Vision, Short Term Disability, Long Term Disability, Life Insurance and 401K.

Job Type: Full-time

Benefits:
  • 401(k)
  • Dental insurance
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance
Medical Specialty:
  • Medical-Surgical
Schedule:
  • 8 hour shift
  • Day shift
  • Monday to Friday
  • Weekend availability
Education:
  • High school or equivalent (Required)


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