In a healthcare account, I worked with Apria- a vendor of CPAP and BiPAP Machine, reviewing needed documents and information from Doctor or patient before calling Insurance company about members coverage and eligibilty to avail CPAP or BIPAP machine for 2 years and 7 months. Then, I worked with Athena as a client partner for prior authorization and referral. I reviewed members medical history, medical intakes and lab results. Upon verification, I used payor's portal like UHC, carelon, Aims, navinet and other payor's portal depending on members insurance company. In both healthcare account, I normally do an outbound calls to verify eligibilty or if prior auth or referral is required. Making sure that HIPAA was strictly implemented or followed.
