Mary Joy Ramil

Healthcare Prior Authorization and Referral Coordinator with 4+ years of experience supporting US healthcare operations. Experienced in prior authorization, precertification, insurance verification, referral coordination, clinical documentation review, payer portal management, and provider communication. Skilled in managing time-sensitive authorization requests, reviewing clinical documentation, coordinating with healthcare providers and insurance representatives, and maintaining accurate documentation across EHR and payer systems.

Cigna Prior Authorization Representative at Sagility (BPO) (2022-03 – 2026-07)

• Processed prior authorization and precertification requests across Cigna, specialty, and multi-TPA healthcare accounts.
• Reviewed clinical documentation, member information, and authorization requirements.
• Coordinated with providers and internal teams to obtain missing information and resolve authorization issues.
• Managed high-volume authorization workflows while maintaining accuracy and compliance with payer guidelines.
• Reviewed and followed up on pending and denied authorization cases.

Independent Contractor – Medical Virtual Assistant / Referral Coordinator at California Outpatient Clinics (Jan 2026- Aug 2026)

• Coordinate specialist referrals and prior authorization requests for three outpatient clinics in Corona, Palm Springs, and Riverside, CA.
• Verify eligibility, benefits, referral requirements, and authorization requirements through payer portals.
• Submit and track authorization requests with clinical documentation and physician orders.
• Follow up on pending, approved, denied, and redirected referrals.
• Coordinate with providers, patients, and insurance representatives regarding referrals and authorizations.

Bachelor Of Technical Teacher in Education in Education – Surigao State College of Technology (2014 – 2018)