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I will provide you efficient and great quality work.

Professional Summary
Detail-oriented healthcare professional with over 3 years of experience in prior authorization,
insurance verification, benefits investigation, referral management, and medical records review
for U.S. healthcare providers. Skilled in coordinating with providers, payers, and healthcare
teams to ensure timely authorization approvals and prevent denials. Proficient in EMR/EHR
systems, HIPAA compliance, CPT, ICD-10, and HCPCS coding. Recognized for maintaining
high-quality standards, reducing turnaround times, and delivering efficient case management.

SKILLS
· Prior Authorization (Specializes in Routine, Genetics, and ICHMO)
· Adheres to confidentiality, State and Federal Law, HIPPA compliance
· Proficient communication with healthcare providers, medical records department, and health information management
· Precise Insurance Verification and Eligibility
· Medical Records Follow-Ups and Verification
· Evaluate member’s benefit plan
· Referral management, Appeals, and Peer-to-peer Coordination

Key Achievements
-Maintained 97-100% in Quality Assurance
-Handles an average of 35-40 cases daily
-Reduced authorization turnaround time by 30-50%
-Prevented delayed or denials through pro-active medical records follow-up



Looking forward to working with you!

Best Regards!

Are you looking for a dependable Virtual Assistant who can combine precision, compassion, and professionalism in handling your administrative and medical support tasks?

-My Expertise Includes:

-Patient coordination, follow-ups, and scheduling
-Managing electronic health records
(EHR/EMR)
-Medical documentation & insurance authorizations
-Data entry, reporting, and clerical support
-Calendar & email management
-HIPAA-compliant administrative assistance

-Why Clients Choose Me:

-Strong background in medical administration & patient care

-Excellent communicator with a warm, professional demeanor

-Highly organized and detail-oriented — I don’t just complete tasks, I perfect them

-Tech-savvy with proficiency in MS Office, Google Workspace, Canva, and EMR tools

-Reliable, compassionate, and committed to quality service

-With a passion for healthcare and a drive for administrative excellence, I help businesses and medical professionals run seamlessly — one task at a time.

Let’s collaborate to bring efficiency, clarity, and care to your daily operations.

-Send me a message — I’d love to help make your workload lighter and your workflow smoother.
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Registered Nurse with extensive experience in medical bill review, claims processing, and healthcare compliance. Skilled in analyzing medical records, ensuring accuracy in billing, and maintaining strict adherence to HIPAA regulations. Proficient in delivering exceptional customer service across diverse industries, consistently achieving high satisfaction scores. Adept at providing back-office support, streamlining administrative workflows, and collaborating with interdisciplinary teams to improve efficiency. Known for strong communication skills, attention to detail, and the ability to simplify complex information for patients, providers, and stakeholders.

I am a certified Medical Billing Specialist with 10+ years of hands-on experience in full-cycle revenue cycle management for healthcare providers. I help practices reduce claim denials, accelerate reimbursements, and keep their billing operations fully compliant so you can focus on patient care.

My core expertise includes:

Insurance verification & eligibility checks
Prior authorization coordination
Accurate medical coding & charge entry (ICD-10, CPT, HCPCS)
Claims submission & follow-up (EDI/paper)
Denial management, appeals & root cause analysis
Payment posting & patient billing
AR reporting, aging analysis & performance tracking

I am experienced with major EMR/EHR systems and billing clearinghouses. I take a proactive approach to denial prevention which identifying trends early and working with clinical teams to resolve documentation gaps before they become revenue losses.

Whether you need a dedicated full-time billing specialist or someone to clean up a backlogged AR, I bring reliability, attention to detail, and a results-driven mindset to every engagement.

What I've Done for Clients

Denial Reduction for a Private Clinic
Working with a solo physician practice that was struggling with a high volume of denied claims, I conducted a full audit of their denial patterns and identified the most common root causes in which including missing prior authorizations and coding mismatches. I restructured their claims review process, coordinated with the clinical team on documentation standards, and implemented a denial tracking system. Within a few months, the practice saw a 20–30% reduction in denial rates, freeing up significant recovered revenue that had previously been written off.

End-to-End Billing Support for a Solo Physician
I provided comprehensive revenue cycle management for a solo physician practice, handling everything from insurance verification and prior authorization to charge entry, claims submission, payment posting, and patient billing. Using Kareo as the practice management system and Office Ally / Availity for claims clearinghouse submission, I maintained a consistent billing workflow that kept AR days low and ensured claims went out clean the first time. The physician was able to focus entirely on patient care with full confidence that billing was handled accurately and on time.

I’m a licensed pharmacist with 6+ years of experience in community pharmacy and hands-on support for U.S.-based healthcare and telehealth clinics. I specialize in prior authorizations, denials, and insurance coordination, with a strong focus on endocrinology, GLP-1 therapies, and chronic care workflows.I help providers move patients forward by managing the entire PA process — from submissions and documentation review to follow-ups, appeals, and pharmacy coordination — so patients can start and continue treatment without unnecessary delays.I’m comfortable working inside U.S. EMRs, insurance portals, and secure chat-based patient messaging platforms, and I’m fully HIPAA-compliant. Teams appreciate me for being organized, responsive, and easy to collaborate with, even in fast-paced environments.


I offer reliable, flexible support and adapt quickly to clinic workflows. If you’re looking for someone who understands both medication workflows and payer requirements, I’d be delighted to connect and explore how I can support your team.

Prior Authorizations Specialist helping healthcare providers secure insurance approvals for the medical procedure needed by their patients without any delay.

Healthcare BPO Specialist with 9+ years of experience in Prior Authorization, Benefits Verification, and Team Leadership. Detail-oriented, performance-driven, and experienced in managing healthcare accounts while maintaining quality and compliance standards.

Medical VA experience | Nursing undergraduate | HIPAA-Trained | EHR & Scheduling
I have a year of experience as A Medical VA with direct client offering services to private practices. My clinical background means I already understand medical terminology, patient care workflows, and the importance of accuracy and confidentiality in healthcare.
What I can help you with:

Patient scheduling, rescheduling, and appointment reminders
Insurance verification and eligibility checks
Prior authorization requests and follow-ups
Medical records management and EHR data entry
Patient intake forms and documentation.

EHR and tools I work with:
Athena health, eClinicalWorks.
What my nursing background brings to the role:

Solid grasp of medical terminology, anatomy, and common diagnoses
Familiarity with patient charting, SOAP notes, and clinical documentation
Strong attention to detail trained through clinical rotations and case studies
Calm, professional communication with patients in stressful situations
Awareness of patient privacy standards and confidentiality

Why work with me:
BS Nursing undergraduate with completed clinical rotations and has a year of experience as Medical Virtual assistant,
HIPAA-trained and committed to patient data confidentiality
Comfortable with both administrative and clinical-adjacent tasks
Available for graveyard, mid, or day shifts
Quiet, private home office with stable fiber internet and backup power
Send me a message and tell me what type of practice you run, what EHR system you use, and what tasks are eating up your front-office hours. I'll let you know how I can help.

I’ve been working remotely for about 4 years now, mostly supporting U.S. and international clients with admin and back office tasks. Healthcare has been my main industry. I handled prior authorizations and insurance verification at Everise, and appointment scheduling at Concentrix. I also did chat and email support for Expedia and Bath & Body Works.

I work well independently and I don’t need much hand holding once I understand the process. I’m familiar with Salesforce, Zendesk, Google Workspace and Microsoft Office and I usually figure out new tools pretty quickly.

Right now I’m looking for a non-voice remote role where I can actually grow with the client long term. Open to part-time or full-time depending on the setup.

I have the ability to meticulously review and ensure accuracy in medical documentation, patient records, and insurance forms. I have a strong verbal and written communication to interact with healthcare providers, patients, and insurance companies to schedule appointments, explain procedures, and assist with inquiries. I am proficient in Microsoft Word, PowerPoint, and Excel, and I possess skills in data entry, email management and EMRs. I am a flexible individual, eager to learn, and open to training in order to effectively handle any tasks assigned to me and produce excellent results.

Registered Nurse in the Philippines with experience in Prior Authorization Provider Support and 2 years of Customer Service experience. Skilled in navigating payer portals, reviewing patient charts, abstracting relevant medical records for authorization approvals, provider communication, case follow-up, and documentation management. Detail-oriented, adaptable, and committed to delivering accurate, efficient, and reliable healthcare support in fast-paced environments.

I help medical professionals, agencies, and healthcare businesses reduce administrative workload, maintain compliance, and focus more on patient care through reliable virtual support.

With experience in insurance verification, prior authorizations, appointment scheduling, and healthcare administration, I support efficient day-to-day operations while ensuring accuracy and timely follow-up.

Areas of Support

Insurance Verification & Prior Authorization

Verifying patient eligibility and benefits
Checking deductibles, copays, coinsurance, and out-of-pocket costs
Determining authorization requirements
Submitting and following up on prior authorization requests
Communicating authorization status and documentation requirements

Front-Office & Patient Support

Appointment scheduling and calendar management
Patient intake and registration
Appointment confirmations and reminders
Patient follow-ups and coordination

Clinical & Documentation Support

Reviewing medical records
Updating patient charts and demographic information
Maintaining accurate documentation

Billing & Administrative Support

Medical billing inquiries
Insurance-related follow-up
General administrative and data entry tasks

Provider & Care Coordination Support

Sending and receiving medical faxes
Requesting medical records from providers and facilities
Tracking inbound and outbound records
Coordinating communication between patients, providers, and insurance companies
Tools & Systems
EHR/EMR systems
Practice Management Systems
Insurance Portals
Secure Healthcare Communication Platforms
Compliance & Professional Standards
HIPAA-compliant handling of Protected Health Information (PHI)
Strong attention to detail and accuracy
Excellent communication and organizational skills
Ability to work independently in a fast-paced healthcare environment

I am committed to providing dependable, professional support that helps healthcare teams improve workflow efficiency and deliver a positive patient experience.

Let's connect and discuss how I can support your practice.

I have over 10 years of experience in healthcare support and virtual assistance, specializing in insurance verification, prior authorizations, patient scheduling, and front desk coordination. I began my career as a Patient Services Representative, where I handled benefits eligibility, processed authorization requests, and ensured accurate patient records in electronic health systems.

I later advanced to a Team Lead role, managing a remote team responsible for the same functions while improving workflow efficiency. In this role, I successfully reduced authorization turnaround times by 20% and handled complex cases by coordinating with healthcare providers and insurance companies, all while maintaining strict HIPAA compliance.

In addition to my healthcare experience, I have strong virtual assistant skills, including inbox management, data entry, client communication, and social media support. I am also proficient in tools such as Google Workspace, ChatGPT, Epic, Athena, payer portals, SalesForce, Zendesk, -----------, which I use to streamline processes and improve productivity in remote work environments.

Overall, my experience has equipped me with strong organizational skills, attention to detail, and the ability to deliver high-quality support in fast-paced, remote healthcare settings.

Dedicated and detail-oriented Customer Service Representative with over 4 years of experience in healthcare and service industries. Skilled in patient scheduling, insurance verification, prior authorization processing, and EHR systems. Acted as a Subject Matter Expert (SME) for Urology practices, providing training, support, and process improvements. Proven ability to manage high call volumes while delivering exceptional service and ensuring timely care coordination. Strong communication and multitasking abilities in fast-paced clinical environments.

Professional Summary

Hi! I'm Anabelle Fallaria, a healthcare professional with over 3 years of combined U.S. healthcare experience specializing in Medication Prior Authorization and Patient Services. Strong knowledge of payer guidelines, insurance requirements, and member support, developed through hands-on remote work in fast-paced, compliance-driven environments. In addition to healthcare, I also bring over 10 years of experience in other industries, engaging directly with customers and strengthening my communication, problem-solving, and service skills.

In my Prior Authorization experience, which is my most recent role, I have worked remotely for over 2 years managing end-to-end prior authorization processes for U.S. healthcare accounts on the payer/PBM side. My responsibilities include reviewing payer requirements, building prior authorization cases from fax requests received from doctor’s offices, verifying patient eligibility and benefits, gathering and analyzing clinical documentation, and coordinated with providers, internal resolution teams, and clinician for case review and escalation as needed.. I have handled routine, complex, and urgent STAT requests, ensuring proper prioritization based on clinical urgency and payer-specific guidelines while maintaining strict HIPAA compliance, documentation accuracy, and workflow efficiency.

In my Patient Services experience, I provided direct support to members and patients by processing prescription refills, handling order status inquiries, tracking medication deliveries, and managing payment and credit balance concerns. I delivered accurate, empathetic, and solution-focused assistance regarding insurance coverage, medication access, pharmacy benefits, and plan details. I also supported providers with eligibility and coverage verification, ensuring smooth coordination across members, pharmacies, and healthcare plans while maintaining compliance with HIPAA and payer guidelines. This role strengthened my communication, problem-solving, and customer service skills while deepening my understanding of the patient journey within the U.S. healthcare system.

Why Work With Me

I bring a strong combination of prior authorization expertise and patient-facing healthcare experience, allowing me to understand both operational workflows and member needs in a healthcare setting. I am highly organized, detail-oriented, and dependable in high-volume, accuracy-critical environments. I work efficiently in remote setups, adapt quickly to new systems and workflows, and consistently maintain strong performance with minimal supervision. I am committed to delivering accurate, timely, and compliant results while ensuring a positive, professional, and supportive experience for both patients and healthcare partners.