Cardiac EVA Specialist

Job Description At ROMTech, we are transforming recovery through innovative technology, data-driven care, and exceptional service. We are committed to improving outcomes by delivering high-quality solutions that support patients, providers, investors, and business partners while fostering a culture of collaboration, accountability, and continuous improvement. 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 Title: Eligibility and Prior Authorization (EVA) Specialist - RCM Department: Revenue Cycle Management (RCM) Reports To: EVA Manager Location / Work Environment: Clearwater, FL | Office Environment FLSA Status: Non-Exempt Job Level: Standard Job Purpose The Eligibility and Prior Authorization (EVA) Specialist is responsible for ensuring accurate and timely insurance eligibility verification, benefits investigation, prior authorization processing, referral validation, and related revenue cycle activities that support ROMTech’s reimbursement and patient service objectives. This role serves as a critical front-end revenue cycle function by confirming coverage requirements, obtaining required authorizations, maintaining payer compliance, and facilitating seamless coordination among internal teams, providers, patients, and payers. The EVA Specialist contributes to operational efficiency, reimbursement integrity, denial prevention, and positive patient experiences through accurate documentation, proactive problem solving, and adherence to regulatory and payer requirements. Key Responsibilities Essential Duties Verify and validate patient demographic information, including name, address, date of birth, insurance information, and other required registration data.Verify patient insurance eligibility, coverage, benefits, limitations, and financial responsibility requirements.Obtain, review, and confirm referrals, authorizations, certifications, and payer approvals as required.Process and document insurance verification and authorization activities accurately and within established timelines.Ensure compliance with HIPAA, CMS, Medicare, Medicaid, OIG, payer requirements, and applicable state and federal regulations.Support accurate assignment and validation of CPT, HCPCS, and ICD-10-CM codes, consistent with established processes and payer requirements.Review documentation to ensure services meet medical necessity and payer coverage requirements.Obtain single case agreements and payer exceptions when necessary to support reimbursement activities.Collaborate with clinical, intake, customer service, billing, sales, and operational teams to obtain missing, incomplete, or unclear documentation.Research and resolve authorization issues, payer discrepancies, claim rejections, and eligibility-related denials.Maintain accurate records within applicable systems and databases.Follow established workflows and performance standards to support revenue cycle objectives.Utilize healthcare technology platforms and business systems to perform verification, authorization, and documentation functions efficiently.Support departmental quality assurance efforts through accurate recordkeeping and process adherence.Maintain confidentiality of patient, payer, and company information at all times. Other Functions Assist with billing-related projects and departmental initiatives as needed.Participate in training, cross-functional projects, and process improvement activities.Support audits, reporting requests, and compliance reviews.Maintain knowledge of payer policies, coverage updates, and reimbursement requirements.Performs other related duties as assigned to support operational and business needs.