Katrina Najarro
Insurance Benefits specialist
Talent
TollesonMember since May 5, 2026
Coverage Criteria AnalysisMulti-Payer Insurance CoordinationPrior Authorization ProcessingDenials, Appeals & Resolution ManagementEHR Documentation SystemsHigh-Volume Case ManagementCross-Functional CommunicationProblem Solving & Critical Thinking
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Coverage Criteria AnalysisMulti-Payer Insurance CoordinationPrior Authorization ProcessingDenials, Appeals & Resolution ManagementEHR Documentation Systems
About
Detail-oriented Insurance Verification Specialist with 3+ years of experience supporting patient access through accurate benefits verification, eligibility research, and prior authorization coordination. Skilled in analyzing insurance coverage across multiple payers, resolving denials, and ensuring timely communication between insurance providers and internal teams. Known for accuracy, efficiency, and the ability to manage high-volume workloads in fast-paced remote environments.
Experience
Insurance Benefits Specialist (Contract) at Triton Medical Solutions (2021-01 – Present)
- Conduct detailed insurance verification, including eligibility, benefits, coverage limitations, and prior authorization requirements across multiple insurance carriers
- Analyze payer-specific criteria to determine coverage approval requirements and ensure accurate patient scheduling and treatment planning
- Utilize payer portals (e.g., Availity, NaviNet) and direct insurance communication to obtain and confirm coverage details such as deductibles, copays, and exclusions
- Process, submit, and track prior authorizations, including follow-up on approvals, denials, and additional documentation requests
- Initiate and manage appeals for denied services, improving approval outcomes through thorough documentation and payer communication
- Secure out-of-network gap exceptions to maintain patient access to medically necessary care
- Maintain accurate and detailed records in EHR systems to ensure compliance and workflow efficiency
- Manage high-volume caseloads while consistently meeting turnaround times and quality standards
- Collaborate with internal teams to resolve insurance-related issues and support seamless patient access to care
Education
associate degree – Glendale Community College (2007)
Skills
Insurance Benefits specialist