Job description

Who We Are:

Cardiovascular Institute of the South, a leading organization dedicated to advancing heart health through innovation and excellence, is part of a national cardiology platform, Cardiovascular Logistics (CVL). Together, we share the same mission to provide our patients with the highest quality cardiovascular care available. Join our team and be a part of an organization that is dedicated to improving patient outcomes and shaping the future of heart health.

What We Offer:

Choice of three health insurance plans
Dental insurance coverage
Vision insurance coverage
401(k) with company match and profit-sharing plan
Company-paid short-term and long-term disability coverage
Company-paid life insurance for you and your family
Access to company-provided training and educational resources
Eligibility for annual merit-based performance increases
Accrued General Purpose Time (GPT)
Eight company-paid holidays
Special company events, including Christmas parties, Family Day, employee engagement activities, and Spirit Days
Complimentary Employee Assistance Program (EAP) for all employees and their dependents

About the Role

Serves a key role in completing prior authorizations for all medical services ordered by CIS providers.
Ensures insurance coverage is verified, patient medical history is reviewed, and scheduling aligns with authorization requirements.
Monitors add-on patient schedules to avoid conflicts and ensure appointments or procedures can proceed with proper approvals.
Acts as a central liaison between CIS departments, insurance companies, and patients to ensure timely and efficient service delivery.

How You’ll Drive Our Mission Forward

Perform pre-certifications for diagnostic tests and procedures (e.g., CT, Nuclear perfusions, PET, ultrasounds, Cath procedures).
Communicate with insurance carriers to submit and track authorizations and appeals.
Review patient chart documentation for accuracy prior to submission.
Accurately use ICD-10 and CPT codes in all prior authorization processes.
Prioritize and manage incoming authorization requests based on urgency.
Follow up on authorization submissions and initiate appeals when requests are denied.
Maintain accurate, standardized documentation of all communications with staff, providers, and payers.
Serve as a resource to clinic staff regarding insurance authorization requirements.
Work daily authorization queues to ensure compliance with payer guidelines and department standards.
Demonstrate a working knowledge of HIPAA regulations, general office procedures, and medical terminology.
Learn and navigate multiple computer systems and software programs required for the role.
Maintain organized and accurate records, making efficient decisions based on available options.
Support the CIS mission by performing other related duties as needed to ensure continuity of care and operational success.

What Makes You a Great Match

Medical terminology knowledge preferred, especially in cardiology.
Prior experience or familiarity with pre-certification and/or hospital admit procedures is a plus.
Strong verbal and written communication skills.
Proficient in computer systems and able to learn new software quickly.
Excellent customer service and interpersonal skills.
Ability to organize, interpret data, and prioritize tasks effectively.
A team player who embraces organizational goals and works independently with minimal supervision.
Comfortable exercising independent discretion and decision-making in a fast-paced environment.