Dynamic Healthcare Medical Assistant with extensive expertise in medical insurance administration, regulatory compliance, and complex claim resolution. Proven track record of managing prior authorizations, medical referrals, and secure portal credentialing while strictly adhering to HIPAA and PHI data privacy guidelines. Skilled in interpreting complex medical claims denials using deep knowledge of CPT, ICD-10, and HCPCS codes to effectively guide members and providers through HMO/PPO benefits and pharmacy formularies. Combines a solid background in data privacy, financial audit workflows, and content regulation with an empathetic, clear communication style to cultivate strong stakeholder relationships and optimize operational efficiency.
Verified
