Divya Botla

I'm currently leading Utilization Review and Prior Authorization operations at ZYTX Software Private Limited, supporting US healthcare RCM case processing from request receipt through closure.

I process review requests through healthcare portals, verify supporting documentation, and coordinate cases with the appropriate clinical reviewer. I handle reviewer determinations by generating approval, denial, and modification letters, uploading documents, and sending required communications.

I maintain case activities, status, notes, and documentation while tracking pending cases to support SLA, TAT, quality, and process compliance. My work is operational and coordination-focused; clinical review and medical-necessity decisions remain with designated clinical reviewers.

With 6+ years in US healthcare RCM and 3+ years as a team lead, I train team members, monitor productivity and accuracy, and prepare performance trackers and updates.