Karimulla Mogal
Bachelor of Pharmacy graduate with US Healthcare Prior Authorization and Revenue Cycle Management experience
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About
Focused and detail-oriented Bachelor of Pharmacy graduate with experience in US Healthcare Prior Authorization and Revenue Cycle Management. Skilled in insurance verification, authorization processing, medical documentation review, payer communication, and HIPAA compliance. Seeking an opportunity to contribute to healthcare operations while expanding professional expertise.
Experience
Process Associate – Prior Authorization Specialist (RCM)
- Processed prior authorization requests for psychiatric medications under US healthcare guidelines.
- Verified patient insurance eligibility, benefits, and coverage requirements.
- Reviewed provider notes and clinical documentation for authorization submissions.
- Submitted authorization requests through payer portals, fax, and electronic systems.
- Followed up on pending, approved, and denied cases to ensure timely resolution.
- Coordinated with providers and insurance companies for additional documentation.
- Assisted with appeals and reconsideration requests.
- Maintained HIPAA compliance and accurate documentation.
Backup Virtual Medical Assistant (VMA) – OB-GYN
- Reviewed and uploaded patient records into EMR systems.
- Managed referrals, lab reports, and insurance documentation.
- Supported providers with chart preparation and document management.
Internship - Active Pharma Labs
1 Month Internship
Education
Bachelor of Pharmacy - Pharmacy - Narayana Pharmacy College, Nellore (2021-01 - 2025-01)
Intermediate - Sri Swarnandhra Bharathi Junior College, Gudur (2021-01)
SSC - Sri G.V.S. Sankaraiah Memorial School (2019-01)
