Authorization Specialist/Customer Support Agent
Current- Reviewed Prior Authorizations requests for medical treatments and approved based on WIN’s medical and contract guidelines
- Reviewed benefits status based on customer plans and eligibility information
- Ensured accuracy and completeness of clinical outcomes and reviewed data entered into ATS (Authorizations Tracking System) by Care Managers
- Tracked and monitor treatment and/or medication modifications
- Contacted Medical Providers, Pharmacies and Insurance Agencies to discuss, clarified and/or confirm accuracy of information received
- Handled complex coverage/benefits issues or questions and troubleshoot for Care Manages or Customers