Virtual AssisUpgrade to see actual infot | Prior Authorization Specialist

Overview

Looking for full-time work (8 hours/day)

at $6.82/hour ($1,200.32/month)

Bachelors degree

Last Active

March 28th, 2024 (31 days ago)

Member Since

March 27th, 2024

Profile Description

5 years of expertise processing diverse prior authorization for all insurance in all states of the U.S., froUpgrade to see actual infodicare, Medicaid, and Managed Care (HMO, PPO). Core specialties include pain management, stimulators, and implantable, sleep studies, imaging, and orthopedic surgeries. Other specialties such as cardiology, oncology, medical procedures, Jcodes and prescriptions, podiatry, and worker's compensation cases.  Expert in utilizing EHR/EMR tools like Athena Health, eclinicalworks, and Practicefusion. Medical billing and payment collection using Ability (Inovalon), GlaceEMR, and CoverUpgrade to see actual infods for prescriptions. Expert in utilizing major provider portals and third-party vendors like Availity, Carelon(AIM), Cohere, Evicore, HealthHelp, RadMD, Quantum, Tricare, UHCs, and DOL(Worker's Comp), etc. Other role includes eligibility verification check, in/out of network check, clinical review, PA status check, processing predetermination, Gap exception, submitting reconsideration, scheduling peer-to-peer reviews, and crafting persuasive appeals.