Surgical Authorization Specialist

Sports Medicine Associates of San Antonio - SMASA; San Antonio (TX); On-site; USD 38,000 - 54,000; Full time

Benefits offered by this job

Medical, Dental, Vision

Paid time off

401K

Job summary

Sports Medicine Associates of San Antonio - SMASA is seeking an Authorization Specialist to join our Business Office and support 15 physicians across 6 clinic locations. You will interpret insurance benefits, obtain authorizations, and review medical policy guidelines to ensure timely patient care.

Ideal candidates have 2+ years in medical authorization/verification, strong communication skills, and proficiency with NextGen EHR or similar systems.

Qualifications

• 2 years medical prior authorization and verification experience.
• 2 years' experience in a medical related field.
• High school diploma or GED required.

Responsibilities

• 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.

Skills

Insurance knowledge

Customer service

Communication skills

Multitasking

Time management

Attention to detail

Education

High School Diploma or GED

Tools

NextGen EHR

Job description

Seeking immediate hire to join our Business Office as an Authorization Specialist in a high-profile Sports Medicine Group supporting 15 physicians and 6 clinic locations.

Responsibilities

• 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.

• 2 years medical prior authorization and verification experience required
• 2 years' experience in a medical related field required

Education

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.

Benefits

• Medical, Dental, Vision, Short Term Disability, Long Term Disability, Life Insurance and 401K
• Paid time off

Medical Specialty

• Medical‑Surgical

Schedule

• 8 hour shift
• Day shift
• Monday to Friday
• Weekend availability