Medical Operation and Insurance Authorization SpecialistMedical Operation and Insurance Authorization Specialist

Key Achievements:

1.Manage end-to-end patient coordination and administrative workflows for a busy multi-provider U.S. medical practice handling 150+ patient inquiries daily. 2.Perform comprehensive Verification of Benefits (VOB) and secure prior authorizations across primary and secondary payers with a 98% clean approval rate. 3.Utilize Epic and athenahealth to manage provider schedules, process patient intakes, collect demographic details, and triage portal messages. 4.Coordinate cross-departmental scheduling and physician referrals, improving appointment compliance by 25%

Key Achievements:

1.Managed intake operations and telehealth scheduling for a high-volume Australian medical clinic using SimplePractice and Open Dental. 2.Conducted pre-appointment outreach, verified Medicare and private insurance details, and confirmed general practitioner referral documents. 3.Triaged patient inquiries and ensured clinical records complied with Australian Privacy Principles (APPs).

Key Achievements:

1.Led real-time insurance eligibility checks and benefit verifications using eClinicalWorks and Practice Fusion. 2.Processed urgent and routine prior authorizations for specialized diagnostic procedures and prescription drugs, reducing backlog by 35%. 3.Handled incoming patient service calls, appointment bookings, and portal inquiries with exceptional empathy and accuracy. 4.Collaborated with billing teams to verify co-pays and deductibles prior to visits, reducing patient payment errors and claims disputes