Process Analyst
CurrentWorking with U.S based Clients as a Process Analyst. • Monitoring incoming orders and gathers information needed to complete the pre-authorization. • Review chart documentation to ensure patient meets medical policy guidelines. • Prioritize incoming authorization requests according to urgency . • Obtain authorization via various payer websites or via phone calls and follow up regularly on pending cases. • Initiate appeals for denied authorizations. • Respond to clinical questions regarding payer medical policy guidelines. • Respond to emails, Calls and other regarding the status of pending or denial cases. • Confirm accuracy of CPT and ICD-10 codes in the procedure order. • Contact Payer Companies through email and Calls to discuss authorization status of pending and denial cases. • Managing group surgeries appt. messages according to their urgencies includes scheduling, rescheduling and cancellation of appts. • Work closely with healthcare providers, insurance companies, and patients to navigate the complex authorization process.
