Prior Authorization Specialist

Prior Authorization Specialist (Medical Assistant)

Location:

Orlando, FL Employment Type:

Full-Time Schedule:

Monday-Friday | Day Shift Join a Leading Cardiovascular Team! The Cardiovascular Center of Florida is seeking a highly organized and detail-oriented Prior Authorization Specialist (Medical Assistant) to join our growing clinical operations team. This role is critical in ensuring patients receive timely access to medically necessary services by obtaining insurance authorizations for procedures, diagnostic testing, imaging, medications, and specialty services. The ideal candidate possesses a strong understanding of medical terminology, insurance verification, payer requirements, and clinical documentation while maintaining a patient-centered approach and exceptional customer service. Position Summary The Prior Authorization Specialist serves as a liaison between providers, patients, insurance carriers, and clinical staff to secure authorizations and referrals necessary for patient care. This position requires strong critical thinking skills, attention to detail, and the ability to navigate complex payer requirements in a fast-paced healthcare environment. Essential Duties & Responsibilities Obtain prior authorizations for diagnostic testing, imaging studies, procedures, surgeries, medications, and specialty referrals Review physician orders and clinical documentation to determine authorization requirements Submit authorization requests through payer portals, electronic systems, fax, or telephone Monitor authorization status and follow up with insurance carriers to ensure timely approvals Communicate authorization determinations, denials, and additional documentation requests to providers and clinical staff Coordinate peer-to-peer reviews and appeals when necessary Verify insurance benefits, eligibility, and coverage requirements Maintain accurate documentation of authorization activity within the electronic medical record system Track authorization expiration dates and ensure approvals remain valid prior to scheduled services Collaborate with physicians, advanced practice providers, medical assistants, scheduling teams, and revenue cycle staff to minimize delays in patient care Stay current on payer guidelines, insurance policies, and authorization requirements Ensure compliance with HIPAA and all applicable regulatory requirements Qualifications Required High School Diploma or GED Current Medical Assistant Certification or equivalent clinical experience Minimum of 2 years of prior authorization experience in a physician practice, specialty clinic, hospital, or healthcare setting Knowledge of insurance verification, referral processes, and payer authorization requirements Strong understanding of medical terminology, CPT, ICD-10, and healthcare documentation Excellent organizational skills and attention to detail Strong written and verbal communication skills Ability to manage multiple priorities and meet deadlines in a fast-paced environment Preferred Cardiology or specialty practice experience Certified Medical Assistant (CMA), Registered Medical Assistant (RMA), or equivalent certification Experience with Medicare, Medicaid, and commercial insurance plans Experience with electronic medical records and practice management systems Appeals and denial management experience What We Offer Competitive Compensation Medical, Dental & Vision Insurance 401(k) Retirement Plan Paid Time Off (PTO) Paid Holidays Company-Paid Life Insurance Professional Development Opportunities Stable Monday-Friday Schedule Collaborative Team Environment Opportunities for Growth Within a Growing Cardiovascular Organization Why Join Us? At The Cardiovascular Center of Florida, our mission is to provide exceptional cardiovascular care while creating a supportive and rewarding environment for our team members. As a Prior Authorization Specialist, you will play an essential role in helping patients receive timely access to the care and treatment they need while supporting the success of our clinical operations. If you are an experienced authorization professional who thrives in a fast-paced healthcare environment and enjoys problem-solving, we encourage you to apply today.

Experience Prior Authorization:

2 years (Required)

Cardiology Prior Authorization:

Preferred Medical Assistant Experience:

Preferred Certifications Medical Assistant Certification (Preferred)

Work Location In Person Benefits:

401(k) 401(k) matching Dental insurance Disability insurance Flexible schedule Flexible spending account Health insurance Health savings account Life insurance Paid time off Professional development assistance Vision insurance

Experience:

Medical Assistant :

1 year (Required)

Prior Authorization:

1 year (Required)

License/Certification:

Certified Medical Assistant (Required)

Work Location:

In person