Prior Authorization Insurance Verification

STACY CURBELO

**** ***** **, *********, ** *****

786-***-**** ************@*****.***

PROFESSIONAL SUMMARY

Healthcare administrative professional with 13+ years of experience in patient access, insurance verification, and prior authorization processes. Proven ability to manage inbound calls and fax systems, verify insurance eligibility, process prior authorizations for procedures, imaging, and medications, and resolve account issues. Skilled in coordinating with payors, providers, and patients to ensure timely approvals, documentation accuracy, and service excellence.

CORE SKILLS

• Insurance Verification & Eligibility Checks

• Prior Authorization Processing (Medications, Imaging, Procedures)

• Patient Access & Account Coordination

• Inbound Call & Fax Management

• Payor, Provider & Patient Communication

• Clinical Support: Vitals, Injections, Diagnostic Testing

• Medical Documentation & Record Management

• Problem-Solving & Issue Resolution

• Process Improvement & Workflow Optimization

• Remote Systems: Microsoft Office, Outlook, MHK, CRM Platforms PROFESSIONAL EXPERIENCE

Insurance Verification Coordinator (Contract)

Healthcare Support – Remote Apr 2025 – May 2025

• Verified insurance eligibility and benefits; updated expired plans in system.

• Completed prior authorizations by obtaining required documentation from physicians and payors.

• Determined patient financial responsibilities and ensured accurate coordination of benefits.

• Managed inbound calls and fax systems for patient account inquiries and authorizations.

• Collaborated with payors, physicians, and patients to resolve account issues promptly.

Prior Authorization Specialist / Rep 1

US Tech Solutions, Inc. / CVS Health – Remote Oct 2023 – Aug 2024

• Processed medication prior authorization requests and ensured compliance with payor requirements.

• Responded to inquiries from patients, providers, and payors regarding coverage and authorizations.

• Maintained accurate records in MHK, People Safe, and Outlook systems.

• Contributed to workflow and service quality improvements. Medical Assistant / Office Manager

South Island Medical Associates – Rockaway Beach, NY Jul 2013 – Oct 2018

• Managed daily operations, trained staff, and handled patient scheduling.

• Performed insurance verification and obtained prior authorizations for procedures

(NST, echocardiogram, carotid duplex, MRI, CT, ultrasounds).

• Prepared claims for submission and ensured accurate documentation in patient records.

• Assisted with clinical care: vitals, venipuncture, injections, and diagnostic procedures (EKG, PFT, Doppler studies, urinalysis).

• Supported multiple specialists including internal medicine, pain management, cardiology, podiatry, and gynecology.

Medical Assistant Supervisor

Sea Girt Medical Associates – Far Rockaway, NY Oct 2010 – Jul 2013

• Verified insurance eligibility and obtained prior authorizations for diagnostic testing and procedures.

• Collected specimens, performed blood glucose, INR, and pregnancy testing.

• Assisted physicians with exams, injections, and suture removal.

• Managed scheduling, documentation, and inbound phone communications.

• Maintained medical records and inventory of office and clinical supplies. Customer Service Specialist

New Balance – Remote Feb 2022 – Jun 2023

• Handled high-volume inbound calls, emails, and chats, ensuring timely issue resolution.

• Documented all customer interactions in CRM for follow-up. Beauty Advisor

Sephora – Remote Jan 2023 – Jul 2023

• Provided virtual client service, resolving inquiries and recommending products. EDUCATION

GED – University of the State of New York

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