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Insurance Verification & Prior Authorization Specialist Comprehensive Cardiology Consultants

LLC - 4.8

Pembroke Pnes, FL Job Details Full-time 14 hours ago Benefits Health insurance Dental insurance 401(k) Flexible spending account Paid time off Vision insurance 401(k) matching Qualifications Spanish Customer communication Medicare Commercial insurance knowledge Managed care Interpersonal skills English Medicaid health insurance Pre-authorization review for utilization management Attention to detail Organizational skills Medicaid Health insurance referral requirements Full Job Description Insurance Verification & Prior Authorization Specialist Comprehensive Cardiology Consultants is seeking a detail-oriented and experienced Insurance Verification & Prior Authorization Specialist to join our growing team. The ideal candidate will have a strong understanding of medical insurance processes, excellent communication skills, and the ability to work efficiently in a fast-paced medical office environment. Position Summary The Insurance Verification & Prior Authorization Specialist is responsible for verifying patient insurance benefits, obtaining authorizations for diagnostic testing and procedures, and ensuring all required documentation is completed accurately and promptly. This role plays a key part in minimizing claim denials and ensuring patients receive timely care. Responsibilities Verify patient insurance eligibility, benefits, coverage, deductibles, copays, and referral requirements. Obtain prior authorizations for testing, procedures, imaging studies, and office services. Submit authorization requests and track approval status with insurance carriers and other verification portals. Review medical records and supporting documentation required for authorizations. Communicate authorization requirements and status updates to providers, clinical staff, and patients. Follow up on pending authorization requests to avoid scheduling delays. Document all insurance and authorization activity accurately in the electronic medical record (EMR). Resolve insurance eligibility and authorization issues in a timely manner. Maintain knowledge of payer guidelines, policies, and authorization requirements. Assist with scheduling and other front-office duties as needed.

QualificationsRequired:

Minimum of 2 years of experience in insurance verification and prior authorizations within a medical office. Strong knowledge of commercial insurance plans, Medicare, Medicaid, and managed care plans. Experience communicating with insurance companies and medical providers. Excellent organizational skills and attention to detail. Strong verbal and written communication skills. Ability to multitask and manage deadlines in a fast-paced environment.

Preferred:

Experience using eClinicalWorks (eCW). Previous experience working in a Cardiology or Cardiac specialty practice. Knowledge of cardiac diagnostic testing, cardiac imaging, stress testing, echocardiography, vascular studies, and related authorizations. Benefits Competitive pay based on experience Paid time off Health benefits Supportive team environment Expected hours: 40.0 per week

Benefits:

401(k) 401(k) matching Dental insurance Flexible spending account Health insurance Paid time off Vision insurance

Work Location:

In person