Cardiology and Vascular Billing Specialist

Location: Port Richey, FL

Position Overview

We are seeking a detail-oriented Cardiology and Vascular Authorization and Billing Specialist to join our team in Port Richey, FL. This role is responsible for ensuring timely insurance approvals (prior authorizations) for cardiac procedures and vein treatments, while managing accurate billing, coding (ICD-10, CPT), and reimbursement processes. The ideal candidate will prevent denials by verifying benefits, providing clinical documentation to payers, and coordinating with clinical staff for peer-to-peer reviews.

Key Responsibilities

• Prior Authorization Acquisition: Obtain authorization for appointments, tests, and complex vascular/cardiovascular procedures by reviewing clinical documentation and understanding payor guidelines.
• Clinical Collaboration: Partner with physicians to gather medical necessity documentation for insurance reviews.
• Billing & Coding: Utilize ICD-10 and CPT codes to ensure proper coding for procedural reimbursement and reduce claim denials.
• Insurance & Benefits Verification: Verify patient eligibility and coverage for specialized services (e.g., vein studies, structural heart studies).
• Denial Management: Research and appeal denied claims.
• Patient Communication: Inform patients of financial responsibilities, including deductibles and self-pay estimates.
• System Proficiency: Use electronic health records (EHR) such as Epic Systems and payer portals to manage cases.

Required Skills and Qualifications

• Experience: Previous experience in cardiology or vascular medical billing/authorizations is a must.
• Knowledge: Detailed knowledge of medical terminology, CPT/ICD-10 coding, and insurance payer requirements.
• Technical Skills: Proficiency in MS Office (Excel, Word) and EHR systems.
• Abilities: Strong attention to detail, multitasking, and ability to work in fast-paced environments.