ROHITH SELVAN

• To follow-up the pending accounts and sent the in-basket message to the provider's office for peer to peer before the authorization case has been denied.
• To follow-up the denied authorization, need to sent the appeal details to the provider office
• For clinicals pending case we have to call the provider's office and get the clinicals, then proceed with medical clinical review for approval
• Pending accounts has been followed through call

Liaise with insurance companies and nurse managers for prior authorization approval.

• Request, track and obtain pre-authorization from insurance carriers within time allotted for medical and services. Request, follow up and secure prior-authorizations prior to services being performed.
• Ensure that proper clinical documentation is in place as needed to obtain prior authorization and Referral.
• Verifying insurance eligibility and benefits
• Understanding and following HIPPA Standard while handling PHI
• Floor Assistance for new hires in US healthcare program.