Praveena M
Process Associate
Madurai
Summary
Results-driven Process Associate at AGS Health with expertise in delivery verification and prior authorization processing. Skilled in insurance eligibility verification and adept at managing payer portals. Committed to ensuring compliance with healthcare guidelines while maintaining high accuracy in documentation. Strong attention to detail and effective communication skills enhance operational efficiency.
Overview
2
2
years of professional experience
Work History
Process Associate
AGS Health
11.2023 - 02.2026
- Performed delivery verification of DME orders to ensure correct patient details, and product accuracy.
- Handled pre-determination and prior authorization for DME services by verifying insurance eligibility and coverage.
- Verified required documents such as prescriptions, CMN (Certificate of Medical Necessity), and insurance details.
- Worked on insurance portals (payer portals) to check eligibility, submit authorization requests, and track claim status.
- Performed delivery verification of DME orders to ensure correct patient details, and product accuracy.
- Handled pre-determination and prior authorization for DME services by verifying insurance eligibility and coverage.
- Verified required documents such as prescriptions, CMN (Certificate of Medical Necessity), and insurance details.
- Worked on insurance portals (payer portals) to check eligibility, submit authorization requests, and track claim status.
- Need to check the physician NPI, and we need to start submitting the authorization with all necessary steps.
- After submitting, we will get an authorization number.
Education
Bachelor of Arts - Computer Application
Ambika Arts And Science College For Women
Madurai, India 04.2001 -
High School Diploma -
Sourashtra Girls Hr. Sec. School
Madurai, India 04.2001 -
Skills
Delivery Verification & Order Accuracy
Pre-Determination / Prior Authorization Processing
Insurance Eligibility Verification
DME Documentation Handling (CMN, Prescriptions)
Payer Portal Management (Eligibility Check & Auth Submission)
Claim Status Tracking & Follow-up
Data Verification & Quality Check
Compliance with Healthcare & Insurance Guidelines
Timeline
Process Associate
AGS Health
11.2023 - 02.2026
Bachelor of Arts - Computer Application
Ambika Arts And Science College For Women
04.2001 -
High School Diploma -
Sourashtra Girls Hr. Sec. School
04.2001 -
Declaration
I hereby declare that the above information is true and correct to the best of my knowledge and belief.
I take full responsibility for the accuracy of the details provided.
Praveena. M