DME & Ortho Therapy EVA Specialist

Eligibility and Prior Authorization (EVA) Specialist - RCM

Job post summary

About Our Company:

ROMTech is a medical technology company that has created and patented a revolutionary medical device and telemedical platform which delivers in-home rehabilitative care. Our disruptive technology has proven to yield faster recoveries and better outcomes with unmatched patient compliance. We began in orthopedics and have entered scale-up of our orthopedic business. We are now leveraging our core technology infrastructure and first mover position to enter cardiology followed by other adjacent markets. Having created this new lane we have a unique opportunity to serve as the global leader in the business technology and science of recovery and to bring life-changing help to many millions of people.

Position Overview:

ROMTech is now looking for a detail-orientedEligibility Verification and Prior-Authorization (EVA) Specialistto join our growing Revenue Cycle Management (RCM) team. The EVA Specialist will play a key role in ensuring accurate compliant and timely verification authorization for services rendered through our remote rehabilitation platform. The ideal candidate will have a thorough understanding of front-end revenue cycle management with first-hand knowledge of CPT codes payer guidelines and electronic health systems. Along with a proven track record of working in fast-paced deadline driven healthcare is a full-time position based onsite at our Clearwater FL corporate office with great potential for growth.

Responsibilities:

• Verify and confirm patient demographics (name address DOB).
• Check insurance eligibility and benefits.
• Confirm insurance referrals and authorizations as required.
• Ensure compliance with HIPAA CMS Medicaid OIG and other state/federal regulations.
• Assign appropriate CPT HCPCS and ICD-10-CM codes to all services.
• Ensure services are completed according to governmental and third-party payer guidelines.
• Accurately complete correct and process insurance verification and authorization.
• Obtain single case agreements where required to secure payment from insurance companies.
• Collaborate with internal teams to gather missing or unclear documentation.
• Resolve claim rejections and resubmit as needed.
• Assist with additional billing-related duties to support division needs.

Skills & Qualifications:

• Capable of multitasking and working efficiently in a fast-paced environment.
• Skilled in using multiple systems to optimize workflows.
• Excellent time management and organizational skills.
• Knowledge of medical terminology orthopedic DME RTM and cardiology payer regulations (preferred).
• Team player with strong communication and collaboration skills.
• Deadline-oriented and proactive in meeting task requirements.
• Comfortable working across departments (intake customer service sales etc.).

Requirements:

• 13 years of recent experience in a revenue cycle management insurance verification and authorization or related role preferred.
• Experience verifying and authorizing for remote therapy monitoring a plus.
• Strong understanding of the full revenue cycle process: patient registration insurance verification charge capture coding billing collections and payment posting is a plus but not required.
• Knowledge of payer requirements and denial management strategies.
• Proficient in the use of industry platforms including: Brightree AdvancedMD RingCentral Slack Zooper iOMS PayCom PandaDoc Microsoft 365 and ServiceNow a plus.
• Typing speed of 6070 WPM is preferred.
• Strong proficiency in Microsoft 365.
• Ability to sit at a computer terminal for an extended period.
• Able to follow company policies and procedures consistently.
• Moderate noise (i.e. phone calls online meetings computer audio)
• While performing the duties of this job the employee may be regularly required to stand sit talk hear reach stoop kneel and use hands and fingers to operate a computer telephone and keyboard.
• Specific vision abilities required by this job include close vision requirements due to computer work.
• Regular predictable attendance is required.