Pre-Authorization Specialist
About The Position
Cardiology Consultants of Philadelphia (CCP), part of Cardiovascular Logistics (CVL), is hiring a full-time Pre-Authorization/Eligibility Specialist at its South Philadelphia, Pennsylvania location. CCP provides comprehensive cardiology care and has more than 30 locations throughout the Philadelphia region. The organization is dedicated to providing high-quality cardiovascular care, improving patient outcomes, and shaping the future of heart health. The specialist verifies insurance coverage and eligibility, obtains referrals and authorizations, communicates insurance information to patients and staff, and helps resolve coverage issues. The role supports patient care and revenue cycle operations while maintaining accurate records and complying with HIPAA and other applicable regulations. The position is eligible for a $500 sign-on bonus, subject to the stated repayment conditions.
Requirements
- Experience in a medical office setting.
- Knowledge of medical insurance plans.
- Ability to multitask.
- Computer knowledge.
- Well-spoken, friendly, and outgoing.
Nice To Haves
- Experience with an EMR system.
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.
- Perform other duties as assigned.
Benefits
- Medical insurance
- Vision insurance
- Dental insurance
- 401(k)
- Profit sharing
- Long-term disability (LTD)
- Generous paid time off
- Paid holidays
- $500 sign-on bonus, subject to the stated eligibility and repayment terms
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What This Job Offers
Job Type
Full-time
Education Level
No Education Listed
