Prior Authorization Assistant, Cardiology
Processes and oversees cardiology prior authorizations, coordinates documentation with healthcare providers and payors, and helps improve AI-powered healthcare workflows. Requires 4+ years of cardiology prior authorization and billing experience plus athenahealth or NextGen proficiency.
About the job
Responsibilities
- Review and verify insurance information and patient eligibility for prior authorizations.
- Communicate with healthcare providers to gather required medical documentation and information.
- Submit prior authorization requests to insurance companies for office visit referrals, procedures, pharmaceuticals, and other services.
- Monitor and track authorization requests to ensure timely processing and resolution.
- Respond to inquiries from providers, patients, and insurance companies regarding authorization status.
- Maintain accurate records of requests, approvals, and denials.
- Collaborate with internal teams to resolve authorization issues and improve process efficiency.
- Process authorizations manually and oversee automated submissions in a high-volume environment.
- Stay current on insurance policies, regulations, and prior authorization industry trends.
Requirements
- 4+ years of prior authorization and billing experience in cardiology.
- Experience with athenahealth and/or NextGen.
- Familiarity with major payors, including UnitedHealthcare, Aetna, and Blue Cross Blue Shield.
- Strong attention to detail, collaboration, adaptability, empathy, and process discipline.
Nice-to-haves
- Client relationship experience.
- Hands-on leadership experience, such as Team Lead, Supervisor, or informal leadership.
- Experience engaging with C-suite executives.
Compensation and Benefits
- Salary range: $45,000–$65,000 annually.
- Meaningful equity.
- Comprehensive health insurance.
- Opportunities for career growth and advancement.
- Exposure to generative AI and automation technologies.
Skills
Prior Authorization, Medical Billing, Cardiology, Athenahealth, Nextgen, Insurance Verification, Patient Eligibility, Unitedhealthcare, Aetna, Blue Cross Blue Shield, Healthcare Documentation, Generative AI
Similar jobs
Pure
Los Angeles, CA
Handles receipt, verification, storage, inventory tracking, and shipment of high-value physical goods in an onsite warehouse environment. Requires warehouse or fulfillment experience, strong attention to detail, physical capability, and adherence to security procedures.
Sprinter Health
Anaheim, CA
Provides in-home phlebotomy, diagnostic, and preventative services, including specimen collection, ECGs, and screenings. Requires venipuncture experience, clinical credentials, reliable transportation, independent work skills, and a strong commitment to compassionate patient care.
Mercury
San Francisco, CAConduct KYC refresh and enhanced due diligence reviews of existing accounts, document account decisions, and escalate risks while supporting BPO partners. The role requires experience in compliance, AML, fraud, banking, risk, or regulatory operations and strong attention to detail.
Applied Intuition
Sunnyvale, CA
Creates and maintains centimeter-precise HD maps for Level 4 autonomous vehicles using lidar, imagery, and 3D geospatial data. The role requires 3+ years of mapping experience, a bachelor’s degree, and familiarity with autonomous-vehicle mapping standards and tools.
Flexport
San Bernardino, CA
Lead and develop a large team of 200+ associates and managers in a fulfillment center. Own operations performance metrics, safety, inventory accuracy, SLA compliance, and continuous improvement initiatives.