- 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
- 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
- 3-4 years medical prior authorization and verification experience required
- 2 years' experience in a medical related field preferred
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
- Medical-Surgical
- 8 hour shift
- Day shift
- Monday to Friday
- Weekend availability
- High school or equivalent (Required)
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Authorization Specialist - San Antonio, United States - Sports Medicine Associates of San Antonio
Description
Job Description
Job DescriptionSeeking 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:
Qualifications:
EXPERIENCE: Previous experience in a similar role required.
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:
Medical Specialty:
Schedule:
Education:
