What are the responsibilities and job description for the Prior Authorization Specialist position at South Tampa Cardiology?
Job Summary:
We are seeking a detail-oriented Cardiology Pre-Authorization Specialist with billing experience to join our team. This role is responsible for securing prior authorizations for cardiology procedures, diagnostic tests, and medications while ensuring compliance with payer policies. The ideal candidate will also have a strong understanding of medical billing and coding practices to support claims processing and reimbursement optimization.
Key Responsibilities:
Pre-Authorization Duties:
- Obtain and verify prior authorizations for cardiology services, including diagnostic imaging, stress tests, catheterizations, and echocardiograms.
- Communicate with insurance companies to secure timely approvals and resolve authorization-related denials.
- Review medical records and clinical documentation to ensure medical necessity requirements are met.
- Coordinate with providers, nursing staff, and administrative teams to facilitate a seamless authorization process.
- Maintain up-to-date knowledge of payer policies and authorization requirements for cardiology services.
Billing & Reimbursement Support:
- Assist in verifying insurance coverage and benefits for cardiology procedures.
- Review and interpret Explanation of Benefits (EOBs) and resolve authorization-related claim denials.
- Collaborate with the billing department to ensure proper coding and documentation align with payer requirements.
- Assist in appeals processes for denied prior authorization requests.
- Maintain detailed and accurate records of authorizations, approvals, and denials.
Qualifications & Skills:
- Experience: Minimum 2-3 years of experience in medical prior authorizations, preferably in cardiology.
- Billing Knowledge: Familiarity with CPT, ICD-10 codes, and medical billing processes related to cardiology services.
- Education: High school diploma required; associate’s or bachelor’s degree in healthcare administration, medical billing, or a related field preferred.
- Technical Skills: Experience with electronic health records (EHR), prior authorization portals, and billing software (e.g., EPIC, Athena, NextGen).
- Communication Skills: Strong verbal and written communication skills to interact with providers, payers, and patients.
- Detail-Oriented: Ability to multitask and work efficiently in a fast-paced environment while ensuring accuracy in authorizations and billing.
- Regulatory Knowledge: Understanding of HIPAA regulations and insurance guidelines.
Benefits:
- Competitive salary based on experience.
- Health, dental, and vision insurance.
- Paid time off and holidays.
- 401(k) with employer match.
- Professional development and training opportunities.
If you are a detail-oriented professional with cardiology pre-authorization expertise and billing knowledge, we encourage you to apply and become part of our dedicated healthcare team.
Job Type: Full-time
Pay: $22.00 - $25.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Work Location: In person
Salary : $22 - $25