With about five years of professional experience, I am dedicated to delivering quality results efficiently while adhering to all turnaround times.Core Skills and Expertise:
INSURANCE VERIFICATION AND AUTHORIZATION MANAGEMENT
Verifying medical eligibility and benefits with health insurance providers, including mental health coverage.Requesting prior or retro authorizations through fax, phone, online portals, and email.Managing gap and special authorization requests.Tracking the status of prior and retro authorization requests.Resolving authorization denials and initiating reconsideration processes.Obtaining approved authorization details promptly.
TECHNOLOGY PROFICIENCY
Experience in using EHR platforms, particularly AthenaHealth.Experienced with various insurance web portals, including Availity, NaviNet, eviCore, AIM, Humana, NIA Magellan, Blue Cross Blue Shield/Anthem BCBS, Tricare Military, United Healthcare, Provider Express.
COMMUNICATION AND COORDINATION
Managing high volumes of emails and making efficient outbound calls.Scheduling peer-to-peer appointments between healthcare providers, such as BCBAs and medical doctors.Handling administrative tasks, including record maintenance and task prioritization.
RELEVANT EXPERIENCE
During my time with a healthcare practice specializing in patients with Autism, I developed exceptional multitasking and organizational skills by:
Handling a large volume of emails and setting task reminders to ensure timely completion of assignments.
Coordinating insurance-related processes, including benefit checks and authorization requests.
Maintaining accurate records and streamlining operational workflows.
ADDITIONAL BACKGROUND
I also bring four years of hands-on experience as a medical technologist and drug test analyst, equipping me with a strong knowledge of medical terminology and laboratory processes. My previous roles include over a year as a pre-certification coordinator, where I specialized in mental health insurance verification, focusing on eligibility, benefits, and authorization procedures.
I am eager to contribute my expertise to a new professional setting, leveraging my strong communication skills, attention to detail, and commitment to delivering excellent results. Let’s collaborate to achieve success!
