Remote Cardiology Prior Authorization Specialist

CardioOne; New York (NY); Remote; USD 29,000 - 37,000; Full time

Benefits offered by this job

Medical, dental, and vision benefits

401K matching

Job summary

CardioOne is seeking an experienced Prior-Authorization Specialist to obtain and verify authorizations, ensuring timeliness and compliance with insurer policies. The role collaborates with providers, patients, and payers to secure approvals and supports the revenue cycle team.

Required are 3–5 years in a similar healthcare role, familiarity with medical billing, and Athena experience. This is a full-time, remote position with benefits and a 401K match.

Qualifications

• Associate's degree in healthcare administration or business administration preferred.
• Minimum of 3–5 years' experience in the same role or related healthcare field.
• Familiarity with medical office procedures and billing practices.
• Cardiology experience preferred.

Responsibilities

• Obtain and verify prior authorizations within required timelines for procedures, tests, and services.
• Verify insurance eligibility and benefit levels to ensure coverage prior to services.
• Coordinate with review organizations and provide medical records or letters of medical necessity when needed.
• Collaborate with clinicians and staff to escalate to peer-to-peer review as required.
• Maintain accurate documentation in all applications and adhere to policies when authorization is not obtained before service date.

Skills

Regulatory compliance

Insurance verification

Education

Associate's degree in healthcare or business administration

Tools

Athena

Job description

CardioOne is seeking an experienced Prior-Authorization Specialist to obtain and verify authorizations, ensuring timeliness and compliance with insurer policies. The role collaborates with providers, patients, and payers to secure approvals and supports the revenue cycle team.

Required are 3–5 years in a similar healthcare role, familiarity with medical billing, and Athena experience. This is a full-time, remote position with benefits and a 401K match.