Sports Medicine Associates of San Antonio - SMASA · 1 week ago
Workers Comp Authorization Specialist
San Antonio, TX
Full-time
Onsite
Mid Level
3+ years expSports Medicine Associates of San Antonio - SMASA is a high-profile Sports Medicine Group seeking an Authorization Specialist to support 18 physicians across 7 clinic locations. The role involves interpreting insurance benefits, obtaining authorizations, and managing authorization requests while ensuring compliance with medical policy guidelines.
Health CareMedicalSports
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
Qualification
Required
Knowledge of commercial and governmental insurance plans (HMO, PPO, EPO, etc.) and payer portals
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
Previous experience in a similar role required
3-4 years medical prior authorization and verification experience required
MUST HAVE 1 year of Workers Comp Experience
High School Diploma Or GED Required
Preferred
Knowledge of NextGen EHR software
2 years' experience in a medical related field preferred
Benefits
401(k)
Dental insurance
Health insurance
Life insurance
Paid time off
Vision insurance
Company
Sports Medicine Associates of San Antonio - SMASA
Sports Medicine Associates of San Antonio is a collective group of San Antonio’s leading orthopedic surgeons and sports medicine physicians.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Adam Roggia PT, DPT, MBA, MS, OCS
Chief Executive Officer
Company data provided by crunchbase