Proactive expert in prior authorization processes, known for strong problem resolution and patient education skills. Committed to improving healthcare access through effective collaboration and timely communication with providers and patients.
Overview
1
1
year of professional experience
Work History
Prior Authorization Specialist
Call-On-Doc
Remote
04.2025 - Current
Processed prior authorization requests for GLP-1 medications.
Reviewed patient insurance benefits to determine coverage eligibility.
Collaborated with team members to resolve complex authorization issues.
Educated patients on the prior authorization process and requirements.
Scheduled peer to peer reviews for physicians to discuss medical necessity with insurance providers.
Notified ordering providers of denied authorizations.
Responded promptly to inquiries from providers, patients and payers regarding status of prior authorization requests.
Processed appeals in a timely manner as per policy guidelines.