Expert Prior Authorization VA | Insurance Verification | Athenahealth • eCW | 5+ yrs US Healthcare

I am a Medical Virtual Assistant with over 5 years of experience supporting U.S. healthcare providers, specializing in prior authorization, insurance verification, and medical administrative support. I have worked with pain management, primary care, podiatry, and wound care practices, helping clinics streamline their authorization workflows and ensure timely approvals for procedures and imaging.

My expertise includes handling prior authorizations for pain management procedures such as lumbar epidural steroid injections (LESI), cervical epidural injections (CESI), medial branch blocks (MBB), radiofrequency ablation (RFA), joint injections, Botox injections, viscosupplementation, and MRI/CT imaging requests. I am familiar with payer guidelines and documentation requirements to reduce denials and speed up approvals.

I have experience working with multiple insurance portals including Evolent, Carelon, Cohere, eviCore, BCBS, Medicare, Tricare, and other commercial plans. I am also proficient in Athenahealth, eClinicalWorks, Aprima, and other EMR systems.

My responsibilities have included:

Submitting and tracking prior authorizations
Insurance verification and eligibility checks
Preparing and submitting appeals and reconsiderations
Reviewing clinical notes for medical necessity
Coordinating with insurance portals and payer representatives
Monitoring pending authorizations and following up for status updates
Communicating with providers and clinical teams regarding authorization requirements

I am highly detail-oriented, organized, and experienced in managing authorization queues to ensure patient services are not delayed.

I am currently open to part-time opportunities as a Prior Authorization Virtual Assistant, preferably non-voice or minimal voice roles, where I can support healthcare providers with authorization processing, insurance coordination, and medical administrative tasks.