Experienced and dedicated Health Care Authorization Specialist with over 5 years of progressive experience in managing outpatient and inpatient authorizations, primarily for Anthem insurance. Recently promoted to Customer Service Representative II in recognition of strong performance, initiative, and leadership potential. Proven ability to navigate complex payer guidelines, complete timely authorizations, and support providers via both chat and telephonic channels. Trained in healthcare systems and workflows, with a strong foundation in claims review, denial resolution, and patient-centered service. Recognized for accuracy, reliability, and excellent communication skills in high-volume, fast-paced environments.
Core Competencies:
Inpatient & Outpatient Authorization
Insurance Verification & Eligibility Checks
Claims Research & Denial Management
Provider Support (Chat & Phone-based)
HIPAA Compliance & Documentation Standards
Cross-functional Collaboration with Clinical & Billing Teams
Strong Organizational & Time Management Skills
Training Participation & Continuous Process Improvement
Customer Service Excellence & Conflict Resolution
