I help Interventional Pain Management clinics eliminate revenue loss caused by insurance delays and denials. With over two years of hands-on US healthcare experience, I specialize in managing end-to-end prior authorizations for spine, joint, nerve, and advanced pain procedures across Medicare, Medicaid, and commercial payers.
I take full ownership of the authorization process—from insurance verification and LCD/NCD-aligned submissions to follow-ups, appeals, and peer-to-peer coordination—ensuring faster approvals and uninterrupted procedure schedules. My work is 100% HIPAA-compliant and focused on accuracy, efficiency, and denial prevention.
Developed hands-on experience, technical proficiency, and workplace readiness to prepare for both employment and further education.
Southeast Pain & Spine Care
(Pain Management Clinic)
• Manage end-to-end prior authorizations for spine, joint, nerve, and advanced pain procedures
• Submit LCD/NCD-aligned requests to Medicare, Medicaid, Tricare, and commercial payers
• Ensure accurate CPT, ICD-10, and modifier application per payer policy
• Track procedure history to comply with frequency and coverage limitations
• Prevent denials through precise documentation and guideline-driven submissions
• Handle appeals, retro authorizations, and peer-to-peer coordination
• Process medication prior authorizations using CoverMyMeds
• Maintain consistent payer follow-ups to secure timely approvals
Highmark BCBS (Pennsylvania & Delaware)
(Health Insurance)
• Verified insurance eligibility, benefits, and cost-sharing details
• Supported authorization, claims, and payer inquiry workflows
• Documented interactions accurately within healthcare systems and EHRs
• Maintained strict HIPAA compliance and data security standards
• Coordinated with providers, clinics, and payer representatives to resolve issues efficiently
End-to-end prior auth support for US pain practices, managing spine, joint, and nerve procedures across Medicare payers.
Insurance Verification Specialist | Ensuring Accurate Benefits, Eligibility, and Revenue Protection for US Clinics Care!