I am a detail-oriented and results-driven Healthcare Virtual Assistant | Medical VA | Prior Authorization Specialist | Appeals Specialist | SME (Subject Matter Expert) with nearly two years of experience supporting US-based healthcare accounts under Humana.
I began my career as a Prior Authorization Specialist, where I handled medication prior authorization requests, insurance verification, benefits investigation, and documentation review with a high level of accuracy and compliance. During training, I ranked as a Top 2 Quality Associate, consistently exceeding performance standards.
I was later promoted to a Post and Pre-Service Appeals Specialist under the Grievance and Appeals Department, where I managed denied claims, appeals processing, case review, utilization review support, and policy compliance. I maintained a consistent 100% KPI performance, demonstrating strong quality assurance, attention to detail, and productivity.
I am known for being highly organized, analytical, and proactive. I have also contributed insights that improved workflow efficiency, case handling, and team productivity.
In addition, I served as a Subject Matter Expert (SME) in both Prior Authorization and Appeals processes. In this role, I:
• Provided process guidance and support to tea-----------mbers
• Assisted in case escalations and complex issue resolution
• Helped improve workflow efficiency and quality standards
• Acted as a go-to resource for policies, procedures, and best practices
I am known for being highly organized, analytical, and proactive, with a strong ability to ensure accuracy, compliance (HIPAA), and high-quality output in fast-paced environments.
Core Skills & Keywords:
• Prior Authorization Processing
• Appeals & Grievance Handling
• Medical Records Review
• Insurance Verification & Benefits Check
• Claims Review & Denial Management
• Healthcare Documentation & Compliance (HIPAA)
• Data Entry & Administrative Support
• Quality Assurance (QA) & KPI-Driven Performance
• Virtual Assistant (Healthcare / Medical VA)
• Email & Case Management
• CRM Tools & Workflow Systems
• Detail-Oriented & High Accuracy Work
I am seeking opportunities as a Medical Virtual Assistant, Healthcare Support Specialist, or General Virtual Assistant, where I can provide accurate, efficient, and reliable remote support to help businesses streamline their operations.
