Healthcare Authorization & Insurance Specialist

Nafisat Adewole

Danville, IN *****

201-***-**** ️ **********@*****.***

Professional Summary

Detail-oriented and reliable healthcare professional with proven experience in insurance verification, prior authorization, and patient financial coordination. Adept at verifying coverage, obtaining pre-certifications, and mitigating insurance denials through appeals and peer-to-peer reviews. Strong understanding of payer guidelines, infusion drug authorization requirements, and patient financial assistance programs. Dedicated to ensuring patients receive timely care and clear communication regarding their financial responsibilities.

Core Skills

Insurance Eligibility & Benefits Verification

Prior Authorization & Pre-certification

Denial Management & Appeals

Patient Financial Counseling

Medical Billing & Reimbursement Knowledge

Payer Guidelines & Regulatory Compliance

EMR Systems (Epic, Athenahealth, Cerner, etc.)

HIPAA Compliance

Multitasking & Time Management

Excellent Verbal and Written Communication

Professional Experience

Verify and document insurance eligibility, benefits, and coverage for all office visits and infusion services.

Obtain insurance authorizations and pre-certifications for office visits and infusion services in accordance with payer requirements.

Facilitate insurance denial mitigation steps including coordinating peer-to-peer reviews and submitting appeals.

Maintain comprehensive knowledge of infusion drug authorization requirements, payer policies, and federal/state coverage guidelines.

Accurately calculate and communicate patient financial responsibility prior to services.

Support patients with financial assistance options by identifying manufacturer copay programs and completing assistance enrollments.

Ensure timely documentation and follow-up on pending authorizations and denials to maintain revenue cycle efficiency.

Patient Financial Coordinator / Medical Authorization Specialist

David Excellence – Chicago, Illinois

April 2022 – September 2025

Verified insurance coverage and obtained pre-authorizations for diagnostic and infusion procedures.

Assisted patients in understanding their insurance benefits and financial obligations.

Communicated with payers to resolve denials and ensure timely approvals for medical services.

Coordinated with billing and clinical teams to streamline authorization and payment processes.

Helped patients enroll in copay and patient assistance programs to reduce financial burden.

Medical Office Administrative Assistant

Southern Illinois health – Chicago, Illinois

January 2016 – March 2022

Supported front-office operations including scheduling, insurance verification, and patient record management.

Assisted with claims preparation and follow-up to ensure timely payment.

Provided administrative support while maintaining compliance with HIPAA and office protocols.

Education

High Honors

Southeastern High school Miami Lakes, FL

September 2020

Certifications

Certified Medical Administrative Assistant (CMAA)

References

Available upon request

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