Detail-oriented Prior Authorization Specialist with almost 10 years of experience in the healthcare industry. Proficient in benefit verification, medical coding, and managing end-to-end authorization request. Skilled in navigating insurance portals, resolving authorization issues, and ensuring compliance with regulatory standards. Proven track record of reducing turnaroud time while coordinating effectively with healthcare providers and insurance companies.

Highly dedicated individual, detail-oriented, ability to multi-task to finish multiple accounts, and experienced in managing full cycle of prior authorization from initial to final approval. I am eager to contribute strong organizational skills and commitment to patient care

I am a dedicated and detail-oriented Medical Virtual Assistant with over 2 years of experience in healthcare support, insurance verification, prior authorizations, claims handling, customer service, and appointment setting.

I specialize in managing the full prior authorization process from start to finish, including submitting authorization requests, following up with insurance companies, documenting outcomes, resolving authorization issues, and ensuring timely approvals for patient services. I also have experience verifying insurance benefits, reviewing claims, and assisting providers and patients with healthcare-related concerns.

My healthcare background has given me strong knowledge of CPT, ICD-10, and HCPCS codes, HIPAA compliance, patient confidentiality, insurance processes, and provider support workflows. I am experienced in handling inbound and outbound calls professionally while maintaining empathy and excellent customer service.

In addition to my medical administrative experience, I also worked as an appointment setter where I handled high-volume outbound calls, contacted 200–250 leads daily, and consistently booked 15 or more successful appointments per day.

Skills & Experience:
• Prior Authorization (Start-to-Finish)
• Insurance Verification & Benefit Checks
• Claims Review & Denial Handling
• Medical Virtual Assistance
• Patient Scheduling & Appointment Setting
• Customer Service & Provider Support
• CPT, ICD-10 & HCPCS Familiarity
• HIPAA Compliance
• EMR/EHR Systems
• Go High Level (GHL)
• Inbound & Outbound Calling
• Data Entry & Documentation

I am fluent in English, highly organized, dependable, quick to learn new systems, and capable of working independently in fast-paced remote environments. I have a reliable computer setup, stable internet connection, noise-canceling headset, and backup equipment ready for remote work.

I am currently seeking a long-term opportunity where I can contribute my healthcare administrative experience, communication skills, and strong work ethic to help support your team and patients effectively.

Experienced healthcare support professional with over 6 years of combined experience in behavioral health billing, insurance verification, prior authorization, provider support, and appointment setting. Skilled in verifying patient eligibility and benefits, reviewing CPT and diagnosis codes, obtaining prior authorizations, and coordinating with insurance providers to ensure accurate coverage information.

Proficient in handling behavioral health accounts, reviewing copays, deductibles, coinsurance, and out-of-pocket costs while maintaining HIPAA compliance and confidentiality. Experienced in claims follow-up, provider advocacy, referrals, and patient scheduling. Strong communication, multitasking, and time management skills with extensive work-from-home experience in fast-paced healthcare environments.

I’m a Medical Billing Specialist with 2 years of experience focusing on high-volume charge entry and payment posting for U.S. healthcare providers.

I support Mental Health, Internal Medicine, Occupational Therapy, and Physical Therapy practices by maintaining accurate claims, properly posted payments, and organized billing records.

My experience includes:
-Charge entry
-ERA/EOB posting
-Insurance verification
-Claim submission
-Clearinghouse review
-AR follow-ups and appeals
-Denial management
-Patient collections

Tools/Systems:
-eClinicalWorks
-Kareo/Tebra
-DrChrono
-Intergy Greenway
-HelloNote
-SimplePractice
-Availity | Office Ally
-Google Workspace
-Microsoft Office

Open to remote opportunities and long-term clinic partnerships.

Dedicated Registered Nurse with 7+ years of clinical experience and 5+ years of remote healthcare support as a Medical Virtual Assistant. Experienced in prior authorization, patient scheduling, medical documentation, insurance verification, and EHR management for U.S.-based healthcare providers. Skilled at managing administrative and clinical workflows, coordinating patient care, and maintaining accurate medical records while ensuring strict HIPAA compliance. Known for strong communication skills, reliability, and the ability to work efficiently in fast-paced healthcare environments.

CORE SKILLS

• Medical Virtual Assistance
• Prior Authorization Processing
• Insurance Verification & Benefits Investigation
• Patient Scheduling & Appointment Coordination
• Medical Documentation & Scribing
• Patient Intake & Chart Preparation
• Referral Coordination
• Medication Authorization (Cover-----------ds)
• EHR / EMR Documentation
• Insurance Portal Navigation
• HIPAA Compliance
• Administrative & Clinical Workflow Support
• Email, Phone, and Patient Communication


HEALTHCARE SYSTEMS & TOOLS

• eClinicalWorks
• AthenaHealth
• Kareo / Tebra
• Practice Fusion
• Brightree
• Cover-----------ds
• Google Workspace
• -----------
• EHR / EMR Systems

-Provides administrative support to ensure efficient operation of office.
-Provides information by answering questions and requests.
-Carries out administrative duties such as filing, typing, copying, binding, scanning etc.
-Contributes to team effort by accomplishing related results as needed.
-Focus on detail.
-Willing to work anytime or any schedule given by the client.

Dynamic Customer Service Representative,sales,tech support, and a Prior Authorization Specialist. Skilled in managing authorization requests, navigating healthcare systems, and working proficiently across multiple EMR portals. Known for strong communication, problem-solving, and delivering efficient, empathetic service in fast-paced environments.

Registered Nurse, with 1 year clinical experience as staff nurse in Tertiary Hospital. I then transition working in BPO industry. I have 5 years experience in US Healthcare Insurance, assigned to Inbound and Outbound calls coordinating with providers for verification of eligibility, reviewing of medical records and providing prior authorization. I am familiar with EHR/EMR such as eClinicalWorks, Tebra, Headway and CRM such as Avaya, Cisco Webex, MS Teams, Google meet.

- Medical Virtual assistant(Podiatry Medical Scribing, Prior Authorization and Insurance verification specialist, Admin Support)
- Medical Records Retrieval Specialist 2 for Law Firms(Cotiviti/Verscend)
- Network and Application support of a medical device company(Dexcom)
- Customer Service and Technical Support Representative(Samsung Electronics)

I am a Registered Nurse (PNLE passer) with solid experience as a Medical Virtual Assistant and Utilization Management Reviewer RN in a multispecialty surgical and healthcare setting. I specialize in insurance verification, benefits checking, prior authorization processing, and utilization review for outpatient and inpatient services.

I have handled high-volume surgical authorizations including breast, reconstructive, and cosmetic procedures, ensuring accurate clinical documentation, timely submissions, and proper coordination with providers, surgery centers, and insurance companies. I am experienced in managing denials, appeals, and follow-ups to secure approvals efficiently.

I am proficient in EMR/EHR systems such as Epic, AthenaOne, OncoEMR, and Symplast, and familiar with insurance portals including Availity, Carelon, UHC, Aetna, Cigna, Humana, Tricare, and others. I am confident in handling end-to-end authorization workflows and maintaining accurate medical records.

I am detail-oriented, organized, and able to work independently in fast-paced environments while ensuring HIPAA compliance, accuracy, and strong communication with healthcare teams.

Core Skills:

Insurance Verification | Prior Authorization | Utilization Management | Denials & Appeals | CPT/ICD-10 Review | Provider Coordination | EMR Documentation | HIPAA Compliance

I am a Medical Virtual Assistant with 4+ years of experience supporting healthcare providers, clinics, and insurance processes. I specialize in insurance verification, prior authorizations, medical billing, and Remote Patient Monitoring (RPM).

I have hands-on experience working with U.S. healthcare systems, handling inbound and outbound calls, verifying benefits (copay, coinsurance, deductibles), and resolving complex claims and billing concerns.

I am highly skilled in:
• Insurance Verification & Benefits Coordination
• Prior Authorization Submission & Follow-ups
• Medical Billing & Claims Review
• Appointment Scheduling & Patient Support
• Remote Patient Monitoring (RPM)
• Patient Engagement & Wellness Check-ins

Tools I’ve used:
Maestro, ICUe, Genesys, RingCentral, eClinicalWorks, Tebra, DrChrono, Availity, and payer portals (UHC, Cigna, etc.)

I focus on delivering accurate, efficient, and compassionate service while helping clinics improve workflow and patient satisfaction.

I am reliable, detail-oriented, and committed to long-term collaboration.

I am a motivated and responsible individual. I can be easily trained. I thrive in fast- paced environments and can adapt to evolving customer needs and company procedures.

Excellent communication and interpersonal skills, able to explain medical information clearly and collaborate effectively with doctors, nurses, and multidisciplinary teams.

Experienced in managing sensitive patient information with confidentiality, ensuring compliance with HIPAA and other healthcare regulations.

Ability to remain calm and focused in fast-paced, high-pressure environments, demonstrating strong problem-solving and critical thinking skills.

Adept at customer service, particularly in addressing patient concerns, resolving issues, and providing a supportive and empathetic patient experience.

Flexible and proactive, with a strong sense of responsibility, reliability, and attention to detail in both patient care and administrative support.

Hi, I’m Rosmae, a detail-oriented Healthcare Virtual Assistant with experience in medical billing, claims processing, prior authorizations, and administrative support. I work closely with healthcare teams to ensure accurate documentation, timely submissions, and smooth coordination with billing departments and providers.

I am highly organized, dependable, and skilled in managing multiple tasks while maintaining accuracy and compliance. My experience includes handling timesheets, verifying claims, coordinating with billing teams, and supporting day-to-day healthcare operations.

I am committed to delivering high-quality work, meeting deadlines, and contributing to an efficient and reliable workflow for both clients and patients.