Prior Authorization Specialist - Healthcare Access & Compliance

Gonzaba Medical Group; San Antonio (TX); On-site; USD 32,000 - 42,000; Full time

Job summary

Gonzaba Medical Group in San Antonio, TX is seeking a dedicated Medical Assistant to support the family practice department by processing prior authorization requests, reviewing medical records for justification, and coordinating with pharmacies and patients. Experience with Athena EMR and CoverMyMeds is important, along with HIPAA compliance and strong customer service.

The role involves handling in-person and telehealth communications, maintaining confidential records, and contributing to a

Qualifications

• Minimum high school education or equivalent and medical assistant certification.
• CPR certification with AED current is required.
• National CMA/RMA/NRCMA certification is preferred/required for continued employment.

Responsibilities

• Process prior authorization requests for medications and DME.
• Handle walk-in and telephonic refill requests and provide updates on prior authorizations.
• Collaborate with Medication Adherence Team to improve adherence metrics.
• Manage the Prior Authorization schedule for requests and renewals.
• Call patients regarding results or changes in medication per provider guidance.

Skills

Prior Authorization

Customer service

Communication

HIPAA compliance

Education

High school diploma

Medical Assistant Certification

Tools

Athena EMR

CoverMyMeds

RightFax

Job description

Gonzaba Medical Group in San Antonio, TX is seeking a dedicated Medical Assistant to support the family practice department by processing prior authorization requests, reviewing medical records for justification, and coordinating with pharmacies and patients. Experience with Athena EMR and CoverMyMeds is important, along with HIPAA compliance and strong customer service.

The role involves handling in-person and telehealth communications, maintaining confidential records, and contributing to a