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Muhammad I
@nasirirshaad
Prior Authorization and Insurance Verification Specialist US Healthcare
Pakistan
Englisch, Urdu
Über mich
I am a dedicated Medical Authorization & Verification of Benefits (VOB) Specialist with 4+ years of leadership experience. Skilled in high‑acuity pain management procedures (ESI, MBB, RFA, SCS, PNS) and proficient in eClinicalWorks, NextGen, and PEHR. I ensure 100% accuracy, HIPAA compliance, and efficient workflow optimization. With a reliable home office setup, I deliver detail‑oriented remote support that helps healthcare practices achieve smooth billing and compliance operations.
Kompetenzen
Muhammad I
offline •
Durchschnittliche Antwortzeit: 1 Stunde
Meine Dienstleistungen
Allgemeine Unterstützung
I will do medical prior authorization and insurance eligibility verification vob
Portfolio
Arbeitserfahrung
Team Lead (Medical Authorization)– Advanced Healthcare Solutions
Advanced Healthcare Staffing Solutions
Mar 2024 - Sep 2026 • 2 yrs 6 mos
Complex Authorization Management Expertly secured prior authorizations for high‑acuity interventional pain procedures (ESI, MBB, RFA, SCS, PNS). Reduced peer‑to‑peer review requirements by auditing documentation against payer guidelines. Verification of Benefits (VOB) Conducted comprehensive eligibility checks for Durable Medical Equipment (DME) and Urine Toxicology (Utox). Accurately identified patient responsibility and coverage limits to prevent front‑end denials. EHR Mastery Managed high‑volume data entry and documentation in eClinicalWorks (eCW), NextGen, and PEHR. Maintained 100% accuracy in patient records and authorization status. Denial & Appeals Leadership Led resolution of denied claims through clinical appeals and direct payer coordination. Consistently overturned rejections, protecting hospital revenue and patient care. Compliance & Quality Assurance Monitored adherence to HIPAA and CMS standards. Conducted regular chart reviews to correct documentation errors and ensure compliance.
Medical Authorization & Verification Specialist
Ascend BPO Services
Apr 2022 - Feb 2024 • 1 yr 10 mos
Experienced in managing complex authorization workflows for high‑acuity interventional pain management and surgical procedures (ESI, MBB, RFA, SCS, PNS). Skilled in conducting comprehensive Verification of Benefits (VOB) and eligibility checks for Durable Medical Equipment (DME) and pump treatments (trial, implant revision, and replacement). Proficient in EHR systems including eClinicalWorks (eCW) and ensuring 100% accuracy in patient records and strict HIPAA compliance. Adept at resolving denied claims through clinical appeals, coordinating directly with insurance providers, and maintaining CMS regulatory standards. Recognized for improving approval turnaround times and reducing front‑end denials through meticulous documentation, workflow optimization, and proactive payer communication.
