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
IDRIS VOHRAIDRIS VOHRA
Application Development Analyst at Accenture Solutions Pvt LtdApplication Development Analyst at Accenture Solutions Pvt Ltd
SHUBHAM PANDEYSHUBHAM PANDEY
Data Research Analyst: Equity at Morningstar India Private limitedData Research Analyst: Equity at Morningstar India Private limited