• Handled outpatient and inpatient prior authorization requests with 100?curacy.
• Initiated authorizations for various medical services, ensuring timely approvals.
• Maintained compliance with healthcare policies and HIPAA regulations.
• Verified patients’ eligibility and benefits to providers to confirm active coverage.
• Checked medical, surgical, and pharmacy benefits to ensure services were covered.
• Explained coverage details, copays, and out-of-pocket costs to providers and patients.
• Assisted in resolving denied claims by clarifying benefits.
• Maintained accurate
documentation of eligibility checks
and benefits verification.
Verified