About this role
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-oriented Eligibility, Verification and Prior-Authorization (EVA) Specialist to 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 environments. This 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.
Qualifications
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:
- 1–3 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 60–70 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.