Gessle Gonzales
Prior Authorization Specialist
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About
3 years of U.S.
Prior
Authorization experience with strong skills in insurance verification, benefits review, payer guidelines, and documentation accuracy. Knowledgeable in ICD-10 coding (L40, L40.50, M45, L70.0) and familiar with CPT/HCPCS codes. Experienced with Commercial Insurance, Medicare, and Medicaid workflows and proficient in EMR/EHR systems Carepath. Reliable remote professional with excellent English communication, attention to detail, and time management.
Experience
Customer Service Representative at Buwelo BPO Solutions (2021-01 – 2024-12)
Worked as a Prior Authorization Specialist, ensuring clear communication, patient support, and service representation with both patients and healthcare providers. Verified equipment, procedures, and medication requirements, tracked authorization statuses, and expedited orders.
- Collaborated with patients and physicians to review and document all necessary medication authorizations with accuracy and efficiency.
Customs support agent at Exela Technologies (2024-01 – Present)
- Tracked and traced domestic and international shipments in real time, providing customers with accurate delivery updates and resolving location or delay inquiries efficiently.
- Coordinated payment processing and shipment releases by clearly communicating billing requirements, ensuring timely dispatch and maintaining a high level of customer satisfaction.
Prior Authorization Specialist (2012-01 – 2016-12)
Education
Bachelor in Elementary Education – Columban College (2012-01 – 2016-12)
