Maricela Deleon
Bullhead City,AZ
Summary
Personable Pharmacy Assistant professional with strong background in guiding and assisting customers, helping coworkers and completing important pharmacy tasks. Productive in efficiently ringing customers, providing information and answering calls to deliver superb customer care. Orderly in recordkeeping, inventory control, ordering products and requesting refills from physicians.
Dedicated administrative professional well-versed in communication and team building. Knowledgeable in medical terminology and scheduling. Ready to bring 10 years of relevant work experience to your team.
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Admissions & Collections Clerk
Riverside University Health System
02.2022 - Current
- Established trust among customers by listening attentively to their concerns and offering feasible solutions tailored to individual circumstances.
- Contributed to a positive work environment through active participation in team meetings and adherence to company policies.
- Maintained productivity and quality standards at all times.
- Served as a reliable source of information for patients regarding appointment scheduling, insurance coverage inquiries, and general office policies.
- Took copayments and compiled daily financial records.
- Applied administrative knowledge and courtesy to explain procedures and services to patients. Managed approximately 50 incoming calls, emails and faxes per day from customers.'
Service Representative
Kaiser Permanente
03.2020 - 02.2022
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction. Managed approximately 50 incoming calls, emails and faxes per day from customers.'
- Streamlined appointment scheduling process by utilizing advanced software tools, optimizing time management for both patients and medical professionals.
- Ensured compliance with HIPAA regulations when handling sensitive patient information, protecting client privacy at all times.
- Managed difficult conversations with compassion and professionalism, helping deescalate tense situations while maintaining a focus on finding resolutions.
- Expanded knowledge on medical terminology and insurance policies through continuous learning initiatives, enhancing accuracy in communication with clients.
Pharmacy Assistant
Costco Mail Order Pharmacy
01.2018 - 01.2020
- Supported operations with filing, copying and faxing.
- Collaborated with healthcare professionals to provide seamless patient care, addressing inquiries regarding medications and dosages.
- Aided in the reduction of prescription errors by meticulously verifying patient information and medication details.
- Coordinated with insurance companies to resolve billing and reimbursement issues.
- Demonstrated professionalism and empathy when handling sensitive patient situations, preserving confidentiality at all times.
- Facilitated effective communication between team members, fostering a collaborative work environment within the pharmacy.
- Updated computer system with current customer, payment and inventory information.
- Answered telephones and provided information about order status, store hours and pharmacy procedures. Managed approximately 40 incoming calls, emails and faxes per day from customers.
Billing Reimbursement Specialist
Option Care Home Infusion
05.2017 - 01.2018
- Strengthened cash flow management through effective monitoring of billed services and prompt collection efforts.
- Maintained compliance with all regulatory guidelines, ensuring accurate billing and documentation practices.
- Achieved increased accuracy in charge capture through thorough review of medical records and patient charts.
- Increased revenue by identifying and rectifying errors in coding, pricing, and data entry of Medications.
- Developed positive relationships with insurance representatives, facilitating smoother claim resolution processes.
- Enhanced reimbursement rates for the organization by efficiently resolving claim denials and underpayments.
- Coordinated with insurance providers to verify customer's policy benefits in relation to claims.
Prior Authorization Specialist
OptumRx
12.2013 - 05.2017
- Verified eligibility and compliance with authorization requirements for service providers.
- Tracked referral submission during facilitation of prior authorization issuance.
- Analyzed trends in denied requests to identify opportunities for process improvement and training.
- Assisted in development of educational materials for patients and providers about prior authorization process.
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Managed a high volume of incoming calls, maintaining professionalism while effectively addressing the needs of callers seeking assistance with prior authorizations. Managed approximately 50 incoming calls, emails and faxes per day from customers.'
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Coordinated with pharmacy staff to ensure timely dispensing of medications following authorization approval.
Education
High School Diploma -
Parkridge Private Academy
Long Beach, CA11-2015
Skills
- Payment processing
- Call center experience
- Account management
- Patient scheduling
- ICD-10 coding
- Medical terminology
- Pharmacology
- Time management
- Customer service
- Complex Problem-solving
- Insurance procedures
- HIPAA compliance
Certification
Medical Terminology - 10/25/2023
ICD 10 & 11 Medical Coding & Billing 2/5/2024
Languages
Spanish
Native or Bilingual
Timeline
Admissions & Collections Clerk
Riverside University Health System
02.2022 - Current
Service Representative
Kaiser Permanente
03.2020 - 02.2022
Pharmacy Assistant
Costco Mail Order Pharmacy
01.2018 - 01.2020
Billing Reimbursement Specialist
Option Care Home Infusion
05.2017 - 01.2018
Prior Authorization Specialist
OptumRx
12.2013 - 05.2017
Medical Terminology - 10/25/2023
ICD 10 & 11 Medical Coding & Billing 2/5/2024
High School Diploma -
Parkridge Private Academy
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