Gilberto Mariduena
Summary
A current Pharmacy Liaison seeking growth and opportunity within a program by expanding my knowledge, skills, and passion to further grow my career.
Overview
6
6
years of professional experience
Work History
Patient Access Specialist/Pharmacy Liaison
AssistRx Patient Solutions
10.2023 - Current
- Maintained patient confidentiality by adhering to HIPAA guidelines and compliance policies.
- Provided exceptional customer service, critical thinking and time addressing patient concerns promptly and professionally.
- Collected and entered patient demographic and insurance data into Salesforce to establish patient's medical record.
- Resolved insurance billing issues promptly to assist patients with financial support while minimizing impact on patients'' financial burden.
- Handled sensitive situations involving distressed patients with empathy maintaining professionalism throughout interactions.
- In charge of assigning cases, calls, emails and voicemails to PAS team with also handling difficult situations with resolution and accuracy.
- As a Specialty Pharmacy Liaison I handled escalations within our specialty pharmacies for our patients with billing, vouchers, shipment, scheduling, correct dosages, and doctor clarification to make sure patients received their medications in a timely manner.
- Performed wide range of pharmacy operations with strong commitment to accuracy, efficiency and service quality.
- Consulted with patient insurance company representatives to complete claims processing, resolve concerns, and for Prior Authorizations.
- Input clinical information such as Adverse Events, Product Complaints, Start Dates and Quality Assurance of the medication.
- Triage prescriptions to pharmacies for patients to assist Health Care Providers.
- Assist pharmacies with processing any copay assistance using vouchers and copay cards.
- Fully trained/Mentor new agents for PAS and provided support after training with any questions or concerns.
Data Invoice Specialist
Cardinal Health
11.2021 - 10.2023
- Investigated and input medical inventory to capture billing data and efficiently process invoices.
- Established strong relationships with key stakeholders, enhancing communication lines for invoicing issue resolution with pharmaceuticals.
- Conducted thorough invoice audits, identifying errors and rectifying discrepancies to maintain accurate financial records.
- Managed high volumes of invoices with exceptional attention to detail, minimizing errors and ensuring timely processing.
- Maintain high attention to detail towards budget rates, cost of medication and products, and process payments with stakeholders and vendors.
- Collaborated with finance team and coworkers to maintain our monthly closing procedure goals and to meet deadlines with invoicing for clients.
Remittance Processor III
Commence Bank
12.2019 - 11.2021
- Demonstrated problem-solving skills when faced with complex situations like inconsistent transactions or suspicious activity; took appropriate action following established protocols to ensure security and compliance were maintained at all times.
- Maintained strict compliance with regulatory guidelines and company policies during all phases of remittance processing.
- Remained adaptable and flexible in a fast-paced environment, readily adjusting to changes in processes or customer requirements while maintaining high levels of performance.
- Expedited processing times for high-priority payments, ensuring timely delivery to recipients.
Insurance Customer Service Representative
AllState
09.2018 - 12.2019
- Managed high call volume while maintaining professionalism, empathy, and attention to detail with each customer.
- Processed policy updates and changes correctly, ensuring client needs were met in a timely manner.
- Answered incoming phone calls to provide information, payments, and updates to customers with assisting current policyholders.
- Responded to customer requests for products, services, and company information.
- Documented customer interactions and transactions for accurate, up-to-date records.
- Assessed customer needs and recommended suitable insurance policies.
Education
High School Diploma -
Paseo Academy of The Fine And Performing Arts
05-2018
Skills
- Benefit Investigations
- Pharmaceutical Invoicing/Reimbursement
- Mentoring/Training
- Accuracy
- Pharmacy escalations
- Insurance
- Patient Support
- Clinical reporting
- Case Management
- Financial support
- Invoicing
- Claims
Additional Information
Tyesha Franklin - AssistRx Patient Solutions
Supervisor
tyesha.franklin@assistrx.com
(816)702-2433
Brooke Bogdan - AssistRx Patient Solutions
Team Lead
(810)953-3743
Timeline
Patient Access Specialist/Pharmacy Liaison
AssistRx Patient Solutions
10.2023 - Current
Data Invoice Specialist
Cardinal Health
11.2021 - 10.2023
Remittance Processor III
Commence Bank
12.2019 - 11.2021
Insurance Customer Service Representative
AllState
09.2018 - 12.2019
High School Diploma -
Paseo Academy of The Fine And Performing Arts
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