I have hands-on experience handling prior/retro/extension authorizations, benefits and eligibility verification, and insurance verification for radiology cases at GWMFA, as well as therapy services (speech, physical, occupational, and hearing) across facilities such as Reload, Optimized, Double Talk, and NexLvl.
I have in-depth knowledge of using EPIC, Availity, EPTAC, Jane, and ClaimMD, as well as various insurance portals such as Humana, Aetna, BCBS, UHC, and UMR. I am familiar with basic medical terminology, including ICD-10 and diagnosis codes. I also know how to determine insurance plan types such as HMO, PPO, Medicare, in-network and out-of-network coverage, and veteran benefits.
