Vivek S.

With over 10 years of experience in the US Healthcare Revenue Cycle Management (RCM) industry, I specialize in Prior Authorization, Insurance Eligibility & Benefits Verification, and Patient Access Services. I help physician practices, hospitals, ambulatory surgery centres, and specialty clinics streamline their front-end operations, reduce claim denials, and accelerate reimbursements. I have extensive experience working with multiple specialties, including Oncology, Radiation Oncology, Pain Management, Pulmonology, Internal Medicine, Urology, Nephrology, Surgery, OB-GYN, Hematology, and Vision Care. My Expertise: Prior Authorization Prior authorization submission for commercial and government payers Radiation therapy, chemotherapy, imaging, surgery, injections, medications, and specialty procedures Medical necessity documentation review Clinical documentation coordination Authorization status follow-up Peer-to-peer coordination Appeals for authorization denials Urgent and expedited authorization requests Tracking authorization validity and extensions Insurance Eligibility & Benefits Verification: Patient demographic verification Eligibility and active coverage verification Deductible, copay, coinsurance, and out-of-pocket verification Referral requirements In-network and out-of-network benefit verification Benefit investigation for specialty services Coordination of Benefits (COB) Medicare, Medicaid, and commercial insurance verification Financial responsibility estimation for patients Additional RCM Services: Patient registration Charge review support Claim status follow-up Denial management Accounts Receivable (AR) support Documentation review Provider credentialing coordination Revenue cycle workflow improvement Software Experience: OncoEMR eClinicalWorks (eCW) Centricity Candid Various payer portals Availity Medicare and commercial insurance portals Why Choose Me? ✔ 10+ years of hands-on US healthcare experience ✔ Strong knowledge of payer guidelines and authorization requirements ✔ Expertise in reducing authorization-related delays and denials ✔ Fast turnaround time with excellent attention to detail ✔ Clear communication and regular status updates ✔ Strict adherence to HIPAA compliance and PHI data security standards ✔ Reliable, organised, and committed to delivering high-quality work My goal is to help healthcare providers improve operational efficiency, minimise revenue leakage, and ensure patients receive timely access to care. If you're looking for a dependable Prior Authorization and Insurance Verification specialist who understands US healthcare workflows, I'd be happy to support your practice.