Yaswanth

Healthcare professional with 2.2 years of experience as an AR Caller and Program Specialist, skilled in insurance follow-ups, denial management, benefits verification, and prior authorization support. Adept at provider and payer communication, case documentation.

Program Specialist – Botox One Drug - Aston Carter

(2025-11 - 2026-03)

• Currently supporting the Botox One Drug patient access program for Neovance
• Managing patient cases end-to-end, including benefits verification and enrollment review
• Assisting healthcare providers with prior authorizations, appeals, and coverage-related inquiries
• Acting as a primary point of contact for providers regarding program and reimbursement support
• Coordinating with internal teams to resolve case issues and reduce treatment delays
• Maintaining accurate case documentation in CRM/case management systems
• Ensuring compliance with HIPAA, SOPs, and client-specific guidelines
• Meeting defined SLAs, quality standards, and productivity metrics

Accounts Receivable Caller - AGS Health PVT. Ltd - Tirupati

(2023-11 - 2025-09)

• Worked on prior authorizations for radiology, surgical, and specialty medication requests across commercial and government payers.
• Reviewed clinical documentation, CPT/HCPCS, and ICD-10 codes to support medical necessity for specialty procedures and treatments.
• Proficient in managing client-facing responsibilities, resolving insurance discrepancies, and ensuring seamless claims processing for Cleveland Clinic.
• Coordinated with insurance providers to obtain prior authorizations for medical procedures, diagnostics, and medications, and followed up on outstanding AR and unpaid claims.
• Experienced Insurance Verification Officer skilled in verifying coverage, updating patient demographics, and reviewing EOBs/ERAs to resolve denials and discrepancies.
• Demonstrated strong communication skills, attention to detail, and thorough knowledge of HIPAA compliance standards.
• Worked on Epic Systems software for reviewing patient accounts, claim details, documentation, and denial follow-up activities.

Bachelor of Degree - B.COM - SV University (2020 - 2023)

Board of Intermediate Education - MPC - SBTM junior College (2018 - 2020)

SSC - Sarada High School (2017 - 2018)