Lilian Tamayo Reyes Registered Nurse

· Process and manage prior authorizations for medications, diagnostic tests, imaging studies, procedures, and specialist referrals.

· Verify patient insurance eligibility, benefits, and coverage requirements.

· Submit, track, and follow up on authorization requests to ensure timely approvals and minimize delays in patient care.

· Assist with appeals, denials, and additional documentation requests from insurance carriers.

· Coordinate referrals, schedule appointments, and facilitate continuity of care.

· Maintain accurate patient records and documentation within EMR/EHR systems while ensuring HIPAA compliance.

· Collaborate with physicians, nurses, pharmacies, insurance companies, and administrative staff to optimize patient services.

· Educate patients regarding insurance requirements, referrals, authorizations, and appointment preparation.