7 years of expertise processing diverse prior authorization for all insurance in all states of the U.S., fro-----------dicare, Medicaid, and Managed Care (HMO, PPO). Core specialties include pain management, neurosurgery, imaging, and orthopedic surgeries. Expert in utilizing EHR/EMR tools like Athena Health, eclinicalworks, and Practice Fusion. Expert in utilizing major provider portals and third-party vendors like Availity, Carelon(AIM), Cohere, Evicore, HealthHelp, RadMD, Quantum, Tricare, UHCs and AI tool like Gemini, Copilot, ChatGPT, Grok, Cloud, and Deepseek. Other role includes Eligibility Verification check, Provider Enrollment, Referrals, Scheduling Peer-To-Peer reviews, Processing Reconsiderations, Clinical Reviews, Gap Exceptions, and crafting persuasive appeals.
