Dexter Baluyot

Results-driven Prior Authorization Specialist with 3 years experience supporting U.S. healthcare operations, with specialized experience in dermatology medications and specialty pharmacy authorizations. Proficient in processing prior authorization requests for specialty medications, including Dupixent, Nemluvio, Ebglyss, Adbry, Cibinqo, and other dermatological therapies. Experienced in comprehensive medical documentation review, payer and clinical criteria assessment, prior authorization submission, denial management, appeals processing, and preparation of Letters of Medical Necessity.

Worked closely with Dermatologists, Allergists/Immunologists, Pulmonologists, and Gastroenterologists to obtain required clinical information and support authorization requirements. Demonstrated ability to collaborate effectively with healthcare providers, insurance companies, and clinical teams to address authorization requirements, resolve denials, and facilitate timely treatment access for patients.

Prior Authorization Specialist at Buwelo Philippines (2022-10 – 2025-10)

3 Years of Experience (October 2022 - October 2025)

• Proficiency in SureScripts and CoverMyMeds Platform
• Processed prior authorization requests accurately and efficiently, ensuring required information and documentation were complete.
• Conducted insurance verification and eligibility checks to support patient access to required healthcare services and medications.
• Reviewed authorization documentation, maintained HIPAA compliance, and handled sensitive patient information with confidentiality.
• Communicated with healthcare providers, insurance companies, and patients to resolve authorization issues and obtain needed information.
• Proficient in handling prior authorization denials and appeals, including the development of Letters of Medical Necessity

– Saguing Elementary School (2004 – 2010)

– Saint John Academy (2010 – 2014)

Bachelor of Science in Computer Engineering in Computer Engineering – AMA Computer College (2016 – 2020)