Insurance Verification, Medical Claims Analyst and Prior Authorization Specialis

I manage the full prior authorization process for services in oncology, cardiology, advanced imaging (MRI, CT, PET), and physical therapy. This includes submitting requests, following up with insurance companies, and ensuring approvals are obtained before treatment. I’m familiar with payer requirements and clinical criteria, and I work closely with providers and schedulers to prevent delays in patient care. I also handle urgent and standard requests through payer portals and EMR systems.

I have solid experience supporting the full revenue cycle, from insurance verification and prior authorization to claims submission, denial management, and reimbursement follow-up. I ensure accurate patient data entry, verify coverage, obtain required authorizations, and work with billing teams to minimize claim rejections. My focus is on reducing delays, improving collections, and supporting clean claim submission—especially for high-cost services in oncology, cardiology, imaging, and physical therapy.

I have hands-on experience verifying insurance coverage for patients across commercial plans, Medicare, and Medicaid. I specialize in high-volume verification for services in medical oncology, cardiology, imaging tests (MRI, CT, PET), and physical therapy. My role includes checking eligibility, confirming benefits, identifying prior auth requirements, and coordinating with payers and providers to avoid delays in patient care. I'm comfortable using portals like Availity and updating information in EMR systems quickly and accurately.