I am a detail-oriented Prior Authorization Specialist with hands-on experience in insurance verification, prior authorization submission, denial follow-up, and provider communication. I specialize in handling medical and pharmacy authorizations, including injectables, specialty medications, ophthalmology procedures, anti-VEGF treatments, laser procedures, and surgical cases.
I am highly experienced in reviewing payer requirements, checking CPT/HCPCS and ICD-10 code alignment, securing approvals, and coordinating with providers, clinics, specialty pharmacies, and patients to prevent treatment delays.
What I can help with:
* Prior authorization submission for medical and pharmacy benefits
* Benefits and eligibility verification
* CPT, HCPCS, ICD-10, and payer guideline review
* Denial and appeal coordination
* Specialty medication and injectable authorization
* Referral and authorization tracking
* Patient communication and appointment coordination
* Provider messaging and clinical documentation follow-up
* Insurance portals and payer phone follow-up
I am known for being accurate, fast, professional, and proactive, ensuring every authorization is worked on with urgency and precision. My goal is to help practices improve approval turnaround times, reduce denials, and keep patient care moving smoothly.
Experience: 5 - 10 years
Experience: 1 - 2 years
Experience: 1 - 2 years
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