Cardiology Prior Authorization Pro

US Heart & Vascular; Houston, Northern (TX, KY); Hybrid; USD 42,000 - 62,000; Full time

Job summary

US Heart and Vascular in Houston, TX is seeking a Cardiology Prior Authorizations Specialist to join Willowbrook Cardiovascular Associates. You will manage prior authorizations for veins, structural heart and CT studies.

The role requires a high school diploma, 3–5 years' experience in medical billing/authorizations, and familiarity with OSHA/HIPAA rules, with ECW experience preferred. Day shift, full-time position.

Qualifications

• Familiar with medical office procedures and billing practices.
• Proficient in clinical documentation review for insurance authorizations.
• Ensure compliance with OSHA, HIPAA and Fraud & Abuse laws.
• High School Diploma or GED required; an Associate’s degree preferred.
• 3–5 years of experience in a similar healthcare role.
• ECW experience is preferred.

Responsibilities

• Ensure timely and accurate insurance authorizations before services.
• Verify insurance eligibility and benefits for identified services.
• Handle pre-certification, authorization, and referral requirements.
• Coordinate and provide information to payers including medical records when needed.
• Collaborate with clinical staff for escalations to peer-to-peer review.
• Communicate with patients and staff to facilitate authorization processes.
• Prioritize urgent cases and document all applications.
• Follow policies if authorization is not obtained before service date.
• Address questions about authorization requirements from providers, staff, and patients.
• Handle escalated authorization requests and mentor team.

Skills

Medical office procedures

Billing practices

HIPAA compliance

Documentation review

Regulatory compliance

Communication

Clinical coordination

Education

High School Diploma or GED

Associate’s degree in healthcare administration or business administration

Tools

ECW

Job description

US Heart and Vascular in Houston, TX is seeking a Cardiology Prior Authorizations Specialist to join Willowbrook Cardiovascular Associates. You will manage prior authorizations for veins, structural heart and CT studies.

The role requires a high school diploma, 3–5 years' experience in medical billing/authorizations, and familiarity with OSHA/HIPAA rules, with ECW experience preferred. Day shift, full-time position.