Medical Prior Authorization Specialist - Cardiology

Medical Prior Authorization Specialist – Cardiology

Heart Solutions of Oklahoma | Oklahoma City, OK

Heart Solutions of Oklahoma is an established, independent cardiology practice seeking an experienced Medical Prior Authorization Specialist to join our team.

The primary responsibility of this position is to obtain and manage insurance prior authorizations for office visits, in-house diagnostic testing, and hospital-based cardiovascular procedures.

Key Responsibilities:

• Obtain prior authorizations for hospital procedures, including cardiac catheterizations, coronary interventions, and other cardiovascular procedures.
• Obtain authorizations for in-office testing, including echocardiograms, nuclear stress tests, vascular ultrasounds, and cardiac monitors.
• Verify insurance eligibility, benefits, referrals, and authorization requirements for new patients and follow-up visits.
• Submit authorization requests through insurance portals and communicate directly with insurance companies.
• Track pending authorizations and follow up to ensure timely approvals.
• Handle authorization denials, appeals, and requests for additional clinical documentation.
• Coordinate with clinical staff, hospitals, and scheduling departments to avoid delays in patient care.
• Maintain accurate documentation of approvals, authorization numbers, and expiration dates.

Qualifications:

• Previous experience with medical insurance prior authorizations is required.
• Familiarity with commercial insurance, Medicare Advantage, and Medicaid plans.
• Knowledge of CPT codes, ICD-10 codes, and medical terminology.
• Experience with insurance portals such as Availity, Carelon, and eviCore.
• Cardiology experience preferred but not required.
• Experience with AdvancedMD is a plus.
• Strong organizational skills, attention to detail, and ability to work independently.
• Excellent communication and problem-solving skills.

Important: This position is primarily focused on prior authorizations. We are looking for someone who already understands the authorization process and can manage requests efficiently with minimal supervision.

To Apply:

Please submit your resume through Indeed and include details of your previous prior authorization experience.

Pay: $19.00 - $24.00 per hour

Expected hours: 36.0 – 40.0 per week

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Application Question(s):

• Have you personally obtained insurance prior authorizations for diagnostic testing or hospital based medical procedures?
• Which insurance authorization portals have you used (e.g., Availity, Carelon, eviCore, or others)?

Experience:

• hands-on medical prior authorization: 1 year (Required)

Work Location: In person

Salary : $19 - $24