Supriya Ausarkar
Mumbai
Summary
Dynamic Prior Authorization Specialist with a proven track record at Harris Computer Systems, enhancing approval rates through analytical problem-solving and clear communication. Successfully trained teams, improving efficiency by 30%. Skilled in claims analysis and adept at navigating insurance protocols, ensuring compliance with HIPAA regulations while fostering strong provider relationships.
Overview
7
7
years of professional experience
Work History
Prior Authorization Specialist
Harris Computer Systems
05.2024 - Current
- Processed average of 150 prior authorization requests per week, achieving 95% approval rate
- Collaborated with healthcare providers to ensure accurate and timely authorization, reducing turnaround time by 20%
- Trained and supervised team of 5 new prior authorization assistants, improving department efficiency by 30%
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Coordinated with billing department to resolve discrepancies related to denied claims due to incomplete or incorrect prior authorizations.
- Streamlined prior authorization processes by implementing efficient tracking systems.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Enhanced communication between healthcare providers and insurance companies, ensuring prompt resolution of issues related to prior authorizations.
- Supported team members by providing guidance on complex cases requiring detailed understanding of medical necessity criteria.
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Improved patient outcomes by expediting authorization process for urgent and life-saving treatments.
- Increased approval rates for necessary medical procedures by providing detailed justifications and patient history during review process.
- Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.
Seniorprocess Associate
Infinx Services Private
01.2021 - 04.2024
- Reduced average processing time for authorizations by 25% through process improvement initiatives
- Implemented electronic authorization system upgrades, leading to 40% increase in workflow productivity
- Oversaw team of 10 prior authorization specialists, providing coaching and performance evaluations
- Verified eligibility and compliance with authorization requirements for service providers.
- Participated in cross-functional initiatives to improve overall efficiency and effectiveness of the prior authorization process for all involved parties.
- Improved provider satisfaction with timely communications regarding authorization status updates.
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Coordinated with billing department to resolve discrepancies related to denied claims due to incomplete or incorrect prior authorizations.
Customer Service Representative
Loginto Health
08.2018 - 10.2019
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
- Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
- Responded to customer requests for products, services, and company information.
- Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from clients.
- Trained new Customer Service Representatives on company policies, procedures, and best practices.
Education
High School Diploma -
Bhavans College
Mumbai, India06-2005
GED -
MN ENGLISH HIGH SCHOOL
Mumbai, India06-2003
Skills
- Understanding of HIPAA regulations
- Claims analysis
- Analytical problem-solving
- Knowledge of insurance protocols
- Workplace professionalism
- Clear verbal communication
- Analytical problem-solving
Hobbies
Time of leisure love to travel explore new places ,Cooking.
Languages
English
Advanced (C1)
Marathi
Bilingual or Proficient (C2)
Hindi
Advanced (C1)
Software
SRS , Next Gen
Timeline
Prior Authorization Specialist
Harris Computer Systems
05.2024 - Current
Seniorprocess Associate
Infinx Services Private
01.2021 - 04.2024
Customer Service Representative
Loginto Health
08.2018 - 10.2019
High School Diploma -
Bhavans College
GED -
MN ENGLISH HIGH SCHOOL
Similar Profiles
Syed AminSyed Amin
Sr. Informatica/IICS Developer at Harris Computer SystemsSr. Informatica/IICS Developer at Harris Computer Systems
Eric SundayEric Sunday
Cloud Security Analyst at Harris Computer SystemsCloud Security Analyst at Harris Computer Systems
Steven FavalaroSteven Favalaro
Regional Sales Manager at CityView, a division of Harris Computer SystemsRegional Sales Manager at CityView, a division of Harris Computer Systems
Arpit ShrivastavaArpit Shrivastava
Group Head at White Rivers MediaGroup Head at White Rivers Media
Sarang R. DesaiSarang R. Desai
Equity Analyst at Ishaan Tradefin LLPEquity Analyst at Ishaan Tradefin LLP