Keesha Dowling

I’m a detail-oriented and highly organized Authorization Specialist with experience in utilization management, medical necessity review, eligibility verification, and provider communication. I secure prior authorizations for outpatient and inpatient needs while ensuring submissions are supported by accurate clinical documentation.

In remote roles, I initiate and track prior authorizations through payer portals, fax, and phone—while monitoring authorization status and following up on pending requests to reduce delays. I review patient charts within electronic medical record systems to ensure clinical documentation is correctly indexed and uploaded for authorization submissions.

I also coordinate with provider offices, case managers, and insurance representatives to resolve missing or incomplete documentation, including urgent requests. From denials management and peer-to-peer reviews to documenting approvals/denials and payer communications in the EHR, I support audit compliance and timely scheduling for patient care.