What are the responsibilities and job description for the Prior Authorization Specialist position at Heart and Vascular Specialist,PC?
At Heart and Vascular Specialists, we are dedicated to providing exceptional cardiovascular care to our patients. Our team is passionate about heart health, and we’re looking for an experienced Prior Authorization Specialist to help us streamline patient access to essential cardiac services.
Position Summary:
The Cardiology Prior Authorizations Specialist is responsible for obtaining timely insurance authorizations for cardiac diagnostic tests, procedures, and medications. The ideal candidate will have a strong understanding of cardiology-related procedures, insurance guidelines, and prior authorization processes.
Job Type:
- Full Time
Responsibilities:
- Coordinate and secure insurance authorizations for cardiology diagnostic tests, procedures (e.g., stress tests, echocardiograms, cardiac catheterizations), and medications.
- Verify insurance coverage and document approvals accurately in the EHR
- Communicate effectively with insurance companies, providers, and patients to gather required documentation.
- Track and follow up on pending authorizations, ensuring timely approval to avoid delays in care.
- Maintain accurate and up-to-date documentation in the electronic health record (EHR) system.
- Assist in appeal processes when authorizations are denied.
- Collaborate closely with the clinical team to ensure patients receive necessary services promptly.
- Maintain compliance with HIPAA and insurance guidelines
Schedule
- Monday to Friday /8 hour shifts / 8:30am-5:00pm
- No weekend / Closed on major holidays
Work Location
- In person
Qualifications:
- High school diploma or GED required; associate degree or healthcare certification preferred.
- Minimum of 2 years of experience in medical prior authorizations, preferably in cardiology or a specialty care setting.
- Strong knowledge of insurance providers, medical terminology, and cardiology procedures.
- Proficient with EHR systems (e.g., Epic, Athena, Pulse) and payer portals and authorization platforms.
- Exceptional organizational and communication skills.
- Ability to work independently in a fast-paced environment.
- Ability to multitask and prioritize in a deadline-driven environment
Preferred Qualifications:
- Familiarity with CMS, Medicare/Medicaid guidelines, and commercial insurance carriers.
- Experience with systems such as Epic, Pulse, or Athenahealth.
- Medical Assistant or Billing Certification a plus but not required
Benefits:
- Competitive salary
- Health, dental, and vision insurance
- 401(k) with employer match
- Paid time off and holidays
How to Apply:
Please submit your resume to Management@hvs.com
Job Type: Full-time
Pay: $23.00 - $26.00 per hour
Expected hours: 36 – 40 per week
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Vision insurance
Ability to Commute:
- Leesburg, VA 20176 (Required)
Ability to Relocate:
- Leesburg, VA 20176: Relocate before starting work (Required)
Work Location: In person
Salary : $23 - $26