At Emrys Billing Solutions, I verify eligibility and benefits, submit prior authorization and referral requests, and follow up with payers until requests are approved or denied. I track authorization units and expiration dates, flag denial risks before services, and work with providers to gather medical necessity documentation.
I also handle authorization-related denials through retro-authorization requests and appeals. I document eligibility checks and authorization steps while supporting Medicare, Medicaid, Medi-Cal, and commercial payer accounts in a fully remote setting.
At HNA Business Group, I followed up on denied, unpaid, and delayed claims, resubmitted corrected claims, and filed appeals under payer-specific guidelines. I also maintained AR aging reports and handled payment posting, adjustments, refunds, and reconciliations.
