Prabjot Singh

Results-driven Senior Prior Authorization Specialist with 7+ years of experience in US Healthcare Revenue Cycle Management (RCM). Expertise in Prior Authorization, Authorization Intake, Notification of Admission (NOA), Insurance Verification, Benefits Verification, and payer communication across Medicare, Medicaid, Medicare Advantage, and Commercial Insurance plans. Proficient in Epic EMR, Availity, Cohere, CareFirst Provider Portal, and UHC Provider Portal.

Consistently processed 35+ authorization requests per day while maintaining a 100% quality score. Strong understanding of payer guidelines, HIPAA compliance, medical terminology, and utilization management workflows.

Senior Executive – Prior Authorization - Access Healthcare Services Pvt. Ltd.

(2022-02)

• Process 35+ Prior Authorization requests daily while maintaining a 100% quality score.
• Verify insurance eligibility, benefits, and authorization requirements.
• Handle inpatient, outpatient, emergency, urgent, and observation authorizations.
• Submit authorization requests through payer portals, phone, and fax.
• Obtain authorization numbers, reference numbers, and case IDs.
• Coordinate with Utilization Management teams for clinical documentation.
• Follow authorization cases through final determination.
• Document all activities accurately in Epic EMR.
• Maintain HIPAA compliance and payer-specific turnaround times.

Prior Authorization Specialist - Jorie Healthcare Pvt. Ltd.

(2021-09 - 2022-02)

• Verified insurance eligibility and benefits.
• Determined payer-specific authorization requirements.
• Submitted authorization requests via payer portals and telephonic channels.
• Coordinated with providers and insurance representatives.
• Followed pending authorizations until approval or denial.
• Maintained productivity and quality metrics.

RCM / Prior Authorization Associate - R1 RCM

(2020-07 - 2021-09)

• Performed insurance verification and benefits verification.
• Reviewed CPT, ICD-10, and HCPCS codes.
• Processed Prior Authorization requests.
• Communicated with payer representatives.
• Maintained accurate authorization documentation.

Medical Billing Associate - MD Everywhere India Pvt. Ltd. (E-MDs Inc.)

(2020-01 - 2020-06)

• Processed medical billing transactions.
• Verified insurance coverage and patient demographics.
• Supported Prior Authorization and Revenue Cycle Management operations.
• Coordinated with insurance companies regarding claim and billing status.

Bachelor of Arts - Arts - Guru Nanak Dev University

Diploma in Computer Applications - Computer Applications - Guru Nanak Dev University