Prior Authorization Specialist

Overview

Looking for any work (8 hours/day)

at $4.74/hour ($912.00/month)

Bachelors degree

Last Active

June 28th, 2026 (today)

Member Since

July 29th, 2022

Profile Description

Greetings! Thanks for visiting my profile.
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!