Virtual Healthcare Assistant with experience supporting multi-specialty practices through provider credentialing, recredentialing, and ongoing payer compliance. Responsible for preparing and submitting credentialing applications, managing follow-ups with payers, and completing CAQH and Availity re-attestations to ensure continuous provider enrollment across various specialties. Experienced in insurance verification, accurately verifying patient benefits and eligibility across all major insurance types, updating coordination of benefits, and providing timely, detail-oriented administrative support to streamline provider onboarding and patient billing workflows.
Experience: 6 months - 1 year
Experienced in provider enrollment and credentialing, with strong knowledge of CAQH maintenance and U.S. payer requirements. Skilled in ensuring accurate provider data, managing documentation, and following up with payers to confirm successful insurance enrollment.
Experience: 1 - 2 years
Verify patient insurance coverage and ensure coordination of benefits is accurate and current. Review backdated insurance and coverage lapses to prevent claim delays and ensure correct billing. Assess eligibility, benefits, and plan restrictions to determine coverage for dates of service.
Experience: 1 - 2 years
Assist members with medication renewals by checking order status, including approvals or denials, and clearly explaining reasons for denial. Initiate prior authorizations when required and provide members with accurate information regarding their financial responsibility. Investigate and resolve member complaints related to medication coverage, shipment delays, and billing discrepancies, while ensuring patient records are accurate and up to date
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