Customer Support (chat, text, email, and phone)

I'm a detail-oriented Prior Authorization and Benefits Verification Specialist with experience supporting U.S.-based infusion centers and specialty clinics. Proven ability to work independently in a remote environment while meeting daily deadlines and authorization turnaround times. Experienced in verifying medical and pharmacy benefits, submitting and tracking prior authorizations, and following up with U.S. insurance payers to ensure timely approvals for infusion therapies.

Strong understanding of U.S. insurance plans and benefit structures, including PPO, HMO, Medicare, Medicaid, and managed care plans. Skilled in infusion-specific workflows such as buy-and-bill verification, drug authorization requirements, site-of-care determinations, and coordination of benefits. Known for strong attention to detail, HIPAA compliance, and accurate documentation that supports clean claims and minimizes treatment delays.

•Prior Authorization (Medical & Pharmacy)
•Infusion Therapy Benefit Verification
•Buy & Bill vs Specialty Pharmacy Review
•Specialty Drug Authorization (J-codes)
•Eligibility & Benefits Verification (E&B)
•Medicare & Medicaid (including secondary payer rules)
•PPO, HMO, EPO Plan Interpretation
•Payer Portal Navigation (Auth Manager, payer websites)
•Insurance Follow-Ups & Status Tracking
•Provider–Payer Communication
•HIPAA-Compliant Documentation
•Remote Work & Independent Case Management
•Deadline-Driven & High-Volume Workflows
•Infusion Center & Specialty Clinic Support