Hi, I'-----------lissa — a healthcare insurance professional with over a decade of hands-on experience in prior authorization, benefits & eligibility verification, and claims & appeals management. If you need someone who can jump into insurance portals, chase down approvals, and actually get things resolved (not just logged), that's exactly what I do best.
A few things I bring to the table:
Healthcare Operations & Insurance:
Prior Authorization Processing (Medical & DME)
Insurance Eligibility & Benefits Verification
Claims Processing & Adjudication
Appeals & Peer-to-Peer (P2P) Review Coordination
Denial Management & Root Cause Documentation
Medical Billing & Payment Resolution
HIPAA Compliance & Patient Data Privacy
Systems & Tools:
Insurance Provider Portals (UHC, multi-payer systems)
EHR / Patient Account Documentation Systems (Salesforce, Waystar, Availity, Provider web portals)
Ticketing & Case Management Systems
MS Office Suite (Word, Excel, Outlook)
Fax, Phone & Portal-Based Submissions
Client & Provider Relations:
Escalation Management (Tier 1–2)
Healthcare Provider Support
Cross-Departmental Coordination
Omnichannel Support (Phone, Email, Chat)
Customer Service & Conflict Resolution
Work Style:
Detail-Oriented Documentation
Independent & Remote Work
Multi-Tasking Under Deadlines
Process Improvement Mindset
I'm detail-oriented, deadline-driven, and genuinely good at navigating insurance red tape so providers and patients don't have to. If you're looking for someone who already knows the ins and outs of US healthcare insurance processes and can hit the ground running, let's talk.
