Cardiac EVA Specialist

ROM TECHNOLOGIES INC•Clearwater, FL

14d•$20 - $23•Onsite

About The Position

The Eligibility and Prior Authorization (EVA) Specialist works in ROMTech’s Revenue Cycle Management department and is responsible for accurate, timely insurance eligibility verification, benefits investigation, prior authorization processing, referral validation, and related revenue cycle activities. The role confirms coverage requirements, obtains required authorizations, supports payer compliance, and coordinates with internal teams, providers, patients, and payers. It contributes to operational efficiency, reimbursement integrity, denial prevention, and positive patient experiences through accurate documentation, proactive problem solving, and adherence to regulatory and payer requirements. The position is based in an office environment in Clearwater, Florida, and reports to the EVA Manager. It is classified as non-exempt. The role also supports billing projects, training, cross-functional initiatives, process improvement, audits, reporting, and compliance reviews, and performs other related duties as assigned.

Requirements

Experience in insurance verification, prior authorization, revenue cycle management, medical billing, healthcare administration, or a related healthcare support function.
Experience working with payer guidelines, eligibility verification, and insurance documentation processes.
Strong attention to detail and accuracy.
Excellent organizational and time management skills.
Ability to multitask and manage competing priorities in a fast-paced environment.
Strong verbal and written communication skills.
Ability to work collaboratively across departments.
Knowledge of insurance eligibility verification and authorization processes.
Proficiency with Microsoft 365 applications.
Ability to learn and navigate multiple software systems simultaneously.
Strong problem-solving and critical-thinking abilities.
Ability to maintain confidentiality and comply with applicable regulations and company policies.

Nice To Haves

Knowledge of orthopedic, DME, RTM, cardiology, and healthcare reimbursement processes.
Familiarity with Brightree, AdvancedMD, RingCentral, Slack, Zooper, iOMS, Paycom, PandaDoc, ServiceNow, or similar platforms.
Typing proficiency of approximately 60–70 words per minute.
Knowledge of denial prevention and resolution strategies.
One to three years of recent experience in revenue cycle management, insurance verification, prior authorization, or related healthcare operations roles.
Experience supporting remote therapy monitoring, rehabilitation services, DME, orthopedics, or cardiology reimbursement functions.
Understanding of the full revenue cycle process, including registration, verification, charge capture, coding, billing, collections, and payment posting.
High school diploma or equivalent.
Associate degree in Healthcare Administration, Medical Billing and Coding, Business Administration, or a related field.
Certified Professional Coder (CPC), Certified Revenue Cycle Representative (CRCR), Certified Medical Reimbursement Specialist (CMRS), or similar healthcare revenue cycle certification.

Responsibilities

Verify patient demographic and registration information, including name, address, date of birth, and insurance details.
Verify insurance eligibility, coverage, benefits, limitations, and financial responsibility requirements.
Obtain, review, and confirm referrals, authorizations, certifications, and payer approvals as required.
Process and document insurance verification and authorization activities accurately and within established timelines.
Comply with HIPAA, CMS, Medicare, Medicaid, OIG, payer requirements, and applicable state and federal regulations.
Support accurate assignment and validation of CPT, HCPCS, and ICD-10-CM codes in accordance with established processes and payer requirements.
Review documentation to ensure services meet medical necessity and payer coverage requirements.
Obtain single case agreements and payer exceptions when needed to support reimbursement activities.
Collaborate with clinical, intake, customer service, billing, sales, and operational teams to obtain missing, incomplete, or unclear documentation.
Research and resolve authorization issues, payer discrepancies, claim rejections, and eligibility-related denials.
Maintain accurate records in applicable systems and databases.
Follow established workflows and performance standards to support revenue cycle objectives.
Use healthcare technology platforms and business systems to perform verification, authorization, and documentation functions.
Support departmental quality assurance through accurate recordkeeping and process adherence.
Maintain confidentiality of patient, payer, and company information.
Assist with billing-related projects and departmental initiatives as needed.
Participate in training, cross-functional projects, and process improvement activities.
Support audits, reporting requests, and compliance reviews.
Maintain knowledge of payer policies, coverage updates, and reimbursement requirements.
Perform other related duties as assigned to support operational and business needs.