Referral job details:
Informing patient via call and text about referral required for the appointments with a specialist provider.
Calling PCP office to obtains referrals for our providers.
Calling insurance companies to obtain referrals details.
Assisting patients via call/text regarding their queries about referrals.
Prior Authorization job details: 
Obtaining CPT codes based on the medical notes/lab reports.
Calling insurance companies to check authorization requirements for surgical/excision procedure codes and for prescriptions as well.
Initiating authorization request via call/insurance portal/fax.
Submitting appeals for denied authorizations.
Assisting provider\'s queries via email regarding prior-authorization.

Used to check the pharmacy and medical coverage of different drug/injections through Healthcare Insurance Companies over the phone.
Used to create and submit Prior Authorization requests to healthcare insurances.
Used to follow up on the status of the submitted Prior Authorization request over the phone. Also submitted appeals for denied Authorization request.
Used to check eligibility of patients through their insurance companies via call.
Used to check the status of the medications over the phone being dispensed through specialty pharmacies.
Used to process claims under pharmacy benefits (Medicare Part D). Also used to call PBM (Pharmacy Benefits Manager) to inquire about the claim rejections.

Creating and submitting claims for different procedures and lab tests to healthcare insurnace companies.


Checking on the status of claim via call and online Insurance portal.
Creating appeals for claims denied due to medical reasons.
Payment posting for paid claims.
Checking eligibility of patient through their healthcare insurnaces.

Outbound US Sales Campaign project.
Provided discounts on the utility bills (electricity, gas and water) of US Citizens.