Lisa Edinger

Verified patient eligibility and authorization requirements according to payer policies and clinical guidelines. Processed prior authorizations for medications, procedures, and services, ensuring accuracy and timely follow-up. Collaborated with healthcare providers to obtain necessary clinical documentation for authorization approvals.

Coordinated insurance benefit verifications and initiated prior authorization requests via phone, fax, and online portals. Ensured compliance with payer policies, state regulations, and HIPAA standards. Utilized EHR systems to track patient data, authorization statuses, and clinical notes.

Handled customer inquiries, resolved billing disputes, and updated account records to ensure accurate information management. Reviewed and processed medical claims, ensuring alignment with insurance guidelines and coverage eligibility. Monitored claims for Medicare and Medicaid compliance, identifying issues and coordinating timely resolutions.

Obtained a High School Diploma from Lifelong Learning Choices in New Castle, PA. This foundational education provided essential skills for future professional development.