Nathan Summa
Pasadena,MD
Summary
Proactive expert in prior authorization processes, known for strong problem resolution and patient education skills. Committed to improving healthcare access through effective collaboration and timely communication with providers and patients.
Overview
1
1
year of professional experience
1
1
year of post-secondary education
Work History
Prior Authorization Specialist
Call-On-Doc
Remote
04.2025 - Current
- Processed prior authorization requests for GLP-1 medications.
- Reviewed patient insurance benefits to determine coverage eligibility.
- Collaborated with team members to resolve complex authorization issues.
- Educated patients on the prior authorization process and requirements.
- Scheduled peer to peer reviews for physicians to discuss medical necessity with insurance providers.
- Notified ordering providers of denied authorizations.
- Responded promptly to inquiries from providers, patients and payers regarding status of prior authorization requests.
- Processed appeals in a timely manner as per policy guidelines.
Education
Associate of Science - Nursing
08.2024 - Current
- 3.5 GPA
High School Diploma -
05-2025
- Maryland House of Delegates Scholarship Recipient
- Student Government Member
- Player for Bowling, 2022 to 2023
- Entire Junior & Senior Year - Honor Roll
Skills
- Patient education and medical terminology
- Insurance verification and prior authorization
- Customer service and problem resolution
- Team collaboration and CoverMyMeds expertise
- ICD-10 coding proficiency
References
References available upon request.
Timeline
Prior Authorization Specialist - Call-On-Doc
04.2025 - Current
Anne Arundel Community College - Associate of Science, Nursing
08.2024 - Current
AACPS Virtual Academy - High School Diploma,