Diana Rose Capuras

Prior Authorization Specialist at Tahche Outsourcing Services | ImageCare Radiology (2023-03 – 2026-01)

Processed prior authorization and managed insurance verification with focus on accuracy and compliance.

• Processed prior auth via portal and phone for various insurance payers
• Verified benefits and coverage requirements
• Monitored and followed up on denied, pending, and clinical review cases
• Reviewed and submitted medical records
• Performed BNE verification and auth request
• Utilized EHR/EMR system for documentation
• Maintained accurate data entry and tracking logs
• Handled inbound provider calls regarding BNE
• Assisted with claims inquiries and resolution
• Processed prior authorization intake request
• Ensured HIPAA compliance during all interactions

Fax Confirmation and Labelling Specialist at Tahche Outsourcing Services | ImageCare Radiology (2021-08 – 2023-03)

Managed fax transmission, document handling, and ensured timely delivery of critical medical results.

• Fax Transmission Monitoring
• Document Management
• Handling Outbound/Inbound Faxes
• Confirmation and Follow-up
• Ensured HIPAA compliance during all interactions
• Compliance and Accuracy
• Ensure timely delivery of critical results (stat/urgent cases)

Provider Service Advocate at Wipro Ltd. | United HealthCare Group (2019-11 – 2021-01)

Provided provider support and processed prior authorization requests for United HealthCare.

• Handled inbound provider calls regarding BNE
• Assisted with claims inquiries and resolution
• Processed prior authorization intake request
• Ensured HIPAA compliance during all interactions

Bachelor of Arts in Psychology – University of Cebu (2015 – 2021)

Bachelor of Science in Marketing Management – University of Cebu (2013 – 2015)