Skills
Acquiring Medical records, Prior authorizations, medical records officer, admin task
5-10 Years
Experience highlights
Prior Authorization Specialist
Private Practice in Psychiatry
·
May/2023
–
Present
May 2023 - May 2025
Handled both prior and retro authorizations with insurers for specialized psychiatry tests, ensuring timely and accurate processing. Played a key role in streamlining prior authorization protocols to improve workflow efficiency. Conducted thorough chart audits to maintain accuracy, compliance, and completeness across all documentation.
Patient & Provider Support Specialist
Apria Healthcare
·
January/2018
–
Present
Served as Subject Matter Expert (SME) for Durable Medical Equipment (DME) processes, verifying patient benefits and eligibility, coordinating document requirements with providers, providing detailed claim status updates and timelines, and collecting claim documents to ensure accurate and timely submissions.
Policyholder Service Representative
EmblemHealth
·
January/2016
–
Present
Verified patient benefits, eligibility, and plan options, scheduled appointments with doctors, and assisted patients with billing inquiries to ensure a seamless healthcare experience.