DME & Ortho Therapy EVA Specialist

Job Details: Job Location: Clearwater, Tech Data Drive - Clearwater, FL, Salary Range: $20.00 - $23.00Hourly, Job Shift: Day, 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.