We are seeking a detail-oriented Cardiology and Vascular Authorization and Billing Specialist to join our team in Port Richey, FL. This role is responsible for ensuring timely insurance approvals (prior authorizations) for cardiac procedures and vein treatments, while managing accurate billing, coding (ICD-10, CPT), and reimbursement processes. The ideal candidate will prevent denials by verifying benefits, providing clinical documentation to payers, and coordinating with clinical staff for peer-to-peer reviews.
Key responsibilities include:
- Obtaining prior authorizations for appointments, tests, and complex vascular/cardiovascular procedures by reviewing clinical documentation and understanding payer guidelines.
- Collaborating with physicians to gather medical necessity documentation for insurance reviews.
- Utilizing ICD-10 and CPT codes to ensure proper coding for procedural reimbursement and reduce claim denials.
- Verifying patient eligibility and coverage for specialized services such as vein studies and structural heart studies.
- Researching and appealing denied claims.
- Informing patients of financial responsibilities, including deductibles and self-pay estimates.
- Managing cases using electronic health records (EHR) such as Epic Systems and payer portals.
Requirements & Qualifications
- Previous experience in cardiology or vascular medical billing and authorizations is required.
- Detailed knowledge of medical terminology, CPT and ICD-10 coding, and insurance payer requirements.
- Proficiency in MS Office (Excel, Word) and EHR systems.
- Strong attention to detail, multitasking abilities, and capacity to work in fast-paced environments.
Location
Florida, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 week ago