Dedicated Healthcare Administrative Professional with over 10 years of diverse experience, including 5+ years of specialization in U.S. Health Insurance and Revenue Cycle Management (RCM).
I am an expert in navigating the full lifecycle of insurance eligibility, prior authorizations, and referrals, ensuring that the "behind-the-scenes" operations of patient care run smoothly.
I leverage a deep understanding of CPT and ICD-10 coding to confir-----------dical necessity and take a proactive approach to eliminate claim denials before they happen. With a background that spans from Accounting and Branch Supervision to Data Annotation and Customer Support, I bring a unique blend of analytical precision and communication excellence to every project. I am committed to 100% HIPAA and PHI compliance and ensuring seamless communication between providers and payers.
Core Competencies
Insurance Management: Prior Authorizations, Eligibility Verification, and Referrals.
Medical Coding: Proficient in CPT and ICD-10 coding for medical necessity.
Compliance: Strict adherence to HIPAA and PHI privacy standards.
RCM Optimization: Proactive denial management and claim lifecycle tracking.
Technical Skills: Data Annotation, Accounting principles, and CRM/Healthcare software.
Communication: 3 years of frontline US Health Insurance customer representation.
Work Experience
Healthcare Administrative Specialist / Prior Authorizations (5+ Years)
Managed the end-to-end authorization process to ensure timely patient care.
Coordinated directly with US insurance payers to verify coverage and resolve clinical documentation gaps.
Customer Service Representative – US Health Insurance (3 Years)
Handled complex inquiries regarding benefits, claims, and policy provisions.
Data Annotation Specialist
Processed and labeled complex data sets with high accuracy to support system optimizations.
Accounting Associate & Spa Branch Supervisor
Managed financial records, supervised staff, and ensured operational efficiency in high-traffic environments.
