US Heart and Vascular is seeking a Cardiology Prior Authorization Specialist to join the team at Birmingham Cardiology in Birmingham, AL. The role focuses on obtaining prior authorizations for veins, structural heart, and CT studies.
Responsibilities include ensuring timely and accurate insurance authorizations before services are rendered, verifying eligibility and benefit levels, coordinating pre-certification and referral requirements, communicating with payer review organizations, collaborating with clinical contacts on peer-to-peer escalations, and working with patients, clinical partners, and financial counselors to support the authorization process. The position also requires accurate documentation, handling escalated requests, supporting departmental needs, and providing team mentorship as needed.
• Familiarity with medical office procedures and billing practices • Proficient in reviewing clinical documentation for insurance authorization requirements • Compliance with regulatory requirements and guidelines, including OSHA, HIPAA, and Federal Fraud and Abuse laws • High school diploma or equivalent required • Associate degree in healthcare administration or business administration preferred • 3–5 years of experience in the same role or a related healthcare field required • ECW experience preferred
Location
Alabama, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
1 week ago