Ricardo Oropeza
El Sobrante
Summary
Highly dedicated and results-driven Patient Access and Reimbursement Specialist with over 12 years of progressive experience in clinical operations, complex case management, and financial navigation across pharmaceutical and clinical service settings. Proven expertise as a committed liaison, simplifying challenging times for patients and families by providing clear guidance, coordinating treatment logistics, and applying strong analytical and reimbursement skills to address barriers to care. Adept at leading teams, ensuring rigorous compliance with HIPAA and SOPs, and developing cross-functional strategies to ensure timely and comprehensive patient support and drive exceptional health outcomes.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Senior Foundation Specialist
Genentech, A Member Of The Roche Group
04.2018 - Current
- Serve as the single point of contact for all cross-portfolio Service Requests from Puerto Rico, expertly navigating unique bilingual and cultural considerations to provide comprehensive operational support.
- Managed and oversaw all high-volume Ocrevus Patient Foundation accounts across the South East - Miami region, demonstrating expertise in coordinating geographically specific patient support services.
- Resolved significant patient financial and insurance burdens by acting as a specialized resource, reviewing eligibility for free medication, and leveraging in-depth knowledge of foundation programs and reimbursement resources.
- Selected as a Foundation Contractor Coach and Pod Lead for the South East Region, responsible for developing, mentoring, and coaching contractor staff to elevate performance and support career advancement goals.
- Conducted constructive call and Service Request reviews as a Peer Monitor (PMT), ensuring consistent delivery of a superior customer experience and rigorous adherence to quality metrics.
Case Manager, Ocrevus/Lucentis Access Solutions
Genentech, A Member Of The Roche Group
08.2016 - 03.2018
- Communicated complex insurance coverage information and authorization requirements to patients, successfully mitigating barriers and facilitating timely infusion treatment logistics.
- Identified and addressed patient financial burdens by thoroughly vetting and referring individuals to appropriate financial assistance programs, leveraging knowledge of reimbursement and funding resources.
- between patients and care providers (physicians/infusion centers) to ensure a superior, coordinated customer experience.
- Informed and educated provider office staff on insurance coverage services and referral resources for financial support, demonstrating proficiency in all aspects of reimbursement and payer policies.
- Managed all patient enrollments, referrals, and fulfillments, ensuring adherence to Standard Operating Procedures (SOPs) through strong organizational skills and attention to detail.
Supervisor of Clinical Operations, CCT
CardioNet Inc., a BioTelemetry Co.
03.2013 - 08.2016
- assistance for complex clinical questions specific to diagnosis and non-clinical inquiries regarding monitoring prescriptions.
- Managed urgent patient situations using Certified Cardiograph Technician (CCT) expertise to interpret EKG findings, promptly contacting patients, and coordinating next steps, including locating the nearest Emergency Room or dispatching EMS.
- Established and managed critical relationships with healthcare providers, Cardiologists, and Field Account Coordinators, acting as a single point of contact to ensure seamless communication and coordinated logistical follow-up for patients.
- Led operational quality by conducting analysis on efficiency measurements, providing data-driven insights, and training/overseeing personnel to ensure strict compliance with HIPAA, Medicare policies, and SOPs.
- Contributed to team development by assisting in annual performance reviews and actively participating in the interview and selection of potential candidates, supporting a high-quality team dedicated to patient care.
Education
No Degree -
University of California-Davis
Davis, CASkills
- Language fluency: Spanish (Native/Bilingual)
- Reimbursement expertise: Foundation programs and co-pay assistance
- Payer policy research and prior authorizations
- Appeals processes and Medicare/Medicaid guidelines
- Compliance: HIPAA and SOP adherence
- Quality assurance and monitoring
- Software proficiency: Microsoft Office Suit
Certification
Medical Interpreting Training School (Spanish)
- Basics of Interpretation
- Ethics and Standards
- Medical Terminology I
- Medical Terminology II
Languages
Spanish
Native or Bilingual
Timeline
Senior Foundation Specialist
Genentech, A Member Of The Roche Group
04.2018 - Current
Case Manager, Ocrevus/Lucentis Access Solutions
Genentech, A Member Of The Roche Group
08.2016 - 03.2018
Supervisor of Clinical Operations, CCT
CardioNet Inc., a BioTelemetry Co.
03.2013 - 08.2016
No Degree -
University of California-Davis