Pre-Authorization Specialist

Cardiology Consultants of Philadelphia; Norristown (Montgomery County); On-site; USD 38,000 - 54,000; Full time

Benefits offered by this job

Sign-on bonus

Job summary

Cardiology Consultants of Philadelphia (CCP) is seeking a full-time Pre-Authorization/Eligibility Specialist at our South Philadelphia, PA location to verify insurance coverage, update patient information, and coordinate referrals and authorizations. The role supports healthcare delivery by ensuring accurate eligibility verification and compliant processing.

The ideal candidate will have medical office experience, familiarity with insurance plans, strong communication skills, and proficiency

Qualifications

• Must have experience in a medical office setting.
• Must have knowledge of medical insurance plans.
• Must have the ability to multitask.
• Computer knowledge is a must.
• Experience with an EMR system is a plus.
• Must be well-spoken, friendly, and outgoing.

Responsibilities

• Verify patient insurance coverage and benefits prior to appointments, procedures, and treatments.
• Review and update patient demographic and insurance information in electronic medical records (EMR) systems.
• Determine patient eligibility for healthcare services based on insurance plan requirements.
• Obtain and document referrals, prior authorizations, and pre-certifications as needed.
• Contact insurance companies to verify coverage, benefits, deductibles, co-pays, and out-of-pocket responsibilities.
• Communicate eligibility and authorization information to patients and clinical staff.
• Resolve insurance discrepancies, denials, and coverage issues in a timely manner.
• Maintain accurate records of all eligibility verification activities.
• Ensure compliance with HIPAA and other applicable healthcare regulations.
• Collaborate with billing, scheduling, and clinical teams to support efficient patient care and revenue cycle operations.
• Assist patients with understanding insurance benefits and financial responsibilities.
• Other duties as assigned

Skills

Multitasking

Computer literacy

Tools

EMR system experience

Job description

Cardiology Consultants of Philadelphia (CCP) is a professional medical organization committed to the healing mission of Medicine and is part of a national cardiology platform, Cardiovascular Logistics (CVL). Together, we share the same mission to provide our patients with the highest quality cardiovascular care available. Join our team and be a part of an organization that is dedicated to improving patient outcomes and shaping the future of heart health.

CCP specializes in providing comprehensive cardiology care and currently has over 30 locations throughout the Philadelphia region. We are currently hiring for a full-time Pre-Authorization/Eligibility Specialist at our South Philadelphia, PA location.

Please note this role is entitled to a $500 sign-on bonus.*

Responsibilities

• Verify patient insurance coverage and benefits prior to appointments, procedures, and treatments.
• Review and update patient demographic and insurance information in electronic medical records (EMR) systems.
• Determine patient eligibility for healthcare services based on insurance plan requirements.
• Obtain and document referrals, prior authorizations, and pre-certifications as needed.
• Contact insurance companies to verify coverage, benefits, deductibles, co-pays, and out-of-pocket responsibilities.
• Communicate eligibility and authorization information to patients and clinical staff.
• Resolve insurance discrepancies, denials, and coverage issues in a timely manner.
• Maintain accurate records of all eligibility verification activities.
• Ensure compliance with HIPAA and other applicable healthcare regulations.
• Collaborate with billing, scheduling, and clinical teams to support efficient patient care and revenue cycle operations.
• Assist patients with understanding insurance benefits and financial responsibilities.
• Other duties as assigned

Requirements

• Must have experience in a medical office setting
• Must have knowledge of medical insurance plans
• Must have the ability to multitask
• Computer knowledge is a must
• Experience with an EMR system is a plus
• Must be well-spoken, friendly, and outgoing

Benefits

Cardiology Consultants of Philadelphia provides medical, vision, dental, 401k, profit sharing, LTD, generous PTO, and paid holiday time.

• If you are hired, and assuming your employment is in good standing, you will receive the sign-on bonus. The bonus will be paid to you no later than 30 days following your start date. In the event that you voluntarily terminate your employment or the Company terminates your employment for cause within 6 months of your date of hire, you will be required to repay the full amount of your sign-on bonus.