Jae

Revenue Cycle | Prior Authorization Specialist

Oct 2026 - Present • 0 mos

Support high-volume prior authorization and revenue cycle workflows for a large healthcare system. Review insurance requirements, clinical documentation, and payer guidelines to identify authorization barriers and resolve account issues. Research payer requirements, document account activity, and coordinate with internal teams to support timely authorization, reimbursement, and revenue cycle follow-up.

Reauthorization Specialist

Sep 2025 - May 2026 • 8 mos

Managed high-volume insurance authorizations, appeals, and payer follow-up for specialty infusion services across multiple insurance plans. Reviewed clinical documentation, medical necessity requirements, and payer guidelines to identify and resolve authorization and reimbursement barriers. Collaborated with providers, payers, and internal teams to obtain documentation and support timely patient care and reimbursement.

Lead Authorization Specialist

Feb 2022 - Aug 2025 • 3 yrs 6 mos

Oversaw insurance verification and prior authorization workflows for outpatient physical therapy, supporting 12+ providers across multiple clinic locations. Researched payer guidelines, reviewed medical documentation, and resolved complex eligibility, authorization, coverage, and reimbursement issues. Trained and onboarded new employees while standardizing insurance workflows, documentation standards, and procedures across clinic locations to improve consistency and efficiency.