Mary

Medical VA/Prior Auth/Insurance Verification/UR Team Lead

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Overview

Looking for full-time work (9 hours/day)

at $10.00/hour ($1,980.00/month)

Bachelors Degree

Last Active

March 28th, 2025 (7 days ago)

Member Since

January 21st, 2023

Profile Description

Results-oriented prior authorization and insurance verification specialist with extensive expertise in behavioral health, including TMS (Transcranial Magnetic Stimulation), radiology, physical therapy, pain management injections, and durable medical equipment (DME). Skilled in managing insurance verifications, initial and concurrent authorizations, peer-to-peer scheduling, and appeal rights follow-ups. Proficient in handling inpatient and outpatient behavioral health authorizations, Single Case Agreements, retro authorizations, and HIPAA-compliant documentation. Adept at collaborating with clinicians, doctors, and utilization reviewers to ensure timely and accurate patient care.

Top Skills

Professional Services » Medical Services

Experience: 5 - 10 years

Customer Support » Insurance » Prior Authorization

Experience: 5 - 10 years

I have over 7 years of hands-on experience working with prior authorizations, insurance verifications, and appeals. I’m used to managing high-volume environments and staying on top of follow-ups to make sure nothing falls through the cracks. I’m also familiar with calculating out-of-pocket costs and handling Single Case Agreements when necessary.