Cardiology Eligibility & Authorization Specialist

ROMTech; Clearwater (FL); On-site; USD 57,308,000 - 66,345,000; Full time

Job summary

ROMTech seeks an Eligibility and Prior Authorization (EVA) Specialist to join our Revenue Cycle Management team in Clearwater, FL. You will verify patient demographics, confirm eligibility, obtain referrals and approvals, and document all activities to support accurate reimbursement.

The role emphasizes HIPAA compliance, payer alignment, and cross-functional collaboration. Ideal candidates have experience in insurance verification, prior authorization, and healthcare billing, with strong

Qualifications

• Experience in insurance verification and prior authorization.
• Experience with revenue cycle management or medical billing.
• Knowledge of payer guidelines and eligibility processes.
• Experience with HIPAA and regulatory compliance.

Responsibilities

• Verify and validate patient demographics and insurance data.
• Verify insurance eligibility and benefits; determine financial responsibilities.
• Obtain and review referrals, authorizations, and payer approvals.
• Document verification and authorization activities within timelines.
• Ensure compliance with HIPAA, CMS, Medicare/Medicaid, and payer rules.
• Aid in coding support with CPT/HCPCS/ICD-10-CM as needed.
• Collaborate with clinical, intake, billing, and operations teams.
• Research and resolve eligibility denials and authorization issues.

Skills

Attention to detail

Organizational skills

Time management

Multitasking

Verbal communication

Written communication

Cross-department collaboration

HIPAA familiarity

Microsoft 365

Software navigation

Education

High school diploma or equivalent

Associate degree in Healthcare Administration or Medical Billing & Coding

Tools

Brightree

AdvancedMD

RingCentral

Slack

Zooper

iOMS

Paycom

PandaDoc

ServiceNow

Job description

ROMTech seeks an Eligibility and Prior Authorization (EVA) Specialist to join our Revenue Cycle Management team in Clearwater, FL. You will verify patient demographics, confirm eligibility, obtain referrals and approvals, and document all activities to support accurate reimbursement.

The role emphasizes HIPAA compliance, payer alignment, and cross-functional collaboration. Ideal candidates have experience in insurance verification, prior authorization, and healthcare billing, with strong