Taha Y.
Junior Healthcare Prior Authorization Specialist
Open to offersNew to PlatformAbout
Taha Y. is a dedicated healthcare administration professional specializing in prior authorization and ICD-10 clinical coding within the US healthcare system. Currently serving as an Authorization Program Specialist at Elusa Health, Taha efficiently manages comprehensive PA workflows using the BV360 portal, ensuring timely authorization decisions by reviewing clinical documentation and coordinating with payers. Previously, Taha contributed as a Clinical Coder at HQ Analytics, focusing on ICD-10 coding and HCC risk adjustment using the eClinicalWorks EHR, thereby enhancing reimbursement accuracy through precise chronic condition coding. With a Doctor of Pharmacy degree from Lahore Pharmacy College and robust training in Revenue Cycle Management from CureMD, Taha’s background in clinical pharmacy enriches their administrative capabilities. This expertise allows for proficient review of physician notes, diagnosis interpretation, and maintaining compliance with HIPAA and payer guidelines.
Experience
Authorization Program Specialist
Elusa Health · 2025 — PresentManaged the complete prior authorization workflows through the BV360 portal, ensuring timely submission and resolution of authorization requests for US payers. Analyzed clinical notes and physician documentation to assess medical necessity based on payer criteria. Prepared and submitted comprehensive prior authorization packages, minimizing interactions with insurance reviewers. Coordinated with provider offices and insurers to support timely authorization decisions, maintaining patient care continuity. Adhered to HIPAA compliance and accuracy standards in all authorization processes.Clinical Coder
HQ Analytics · 2025 — 2025Reviewed patient records within eClinicalWorks (eCW) EHR to conduct precise ICD-10 diagnosis coding for diverse clinical encounters. Focused on HCC risk adjustment coding for chronic conditions, aiding in reimbursement accuracy. Assessed physician notes and lab results to assign codes that reflected patient acuity. Ensured detailed progress notes and coding documentation for audit readiness and care record continuity.Clinical Rotations
Ghurki Trust Teaching Hospital · 2023 — 2024Contributed to patient history collection and prescription analysis under clinical supervision. Acquired a strong understanding of patient care workflows, medication management, and clinical documentation that supports healthcare administration.Medical Billing & RCM Training
CureMDParticipated in a structured RCM boot camp, learning the US medical billing lifecycle from patient registration to payment posting. Developed a foundational understanding of the revenue cycle's key processes and roles. Gained insights into commercial, Medicare, and Medicaid insurance structures and their influence on claims and reimbursement.
Skills & Expertise
Education
- Doctor of Pharmacy (Pharm.D)Lahore Pharmacy College · 2019 — 2025
- Intermediate — Pre-MedicalPunjab College · 2015 — 2017
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