Benjamin Acevedo
San Sebastian
Summary
Professional with extensive experience in the pharmaceutical sector and healthcare claims adjudication. Proven track record of meeting customer needs and driving organizational success. Exceptional organizational skills support effective management of complex projects in dynamic environments. Strong analytical and collaborative abilities enhance problem-solving and ensure compliance with regulatory standards.
Overview
25
25
years of professional experience
1
1
Certification
Work History
Senior Process Associate
Infosys
Aguadilla
01.2024 - Current
- Healthcare claims adjudication
- Knowledge of CPT, ICD-9/10 and HCPC codes
- Responsible for accurate and timely processing of healthcare claims
- Reviews and evaluates the service request as per SOP
- Familiar with medical policy, UCSW service requests, correspondence inquiries and image review
- Claim adjudication plattform
- Team work
- Detailed oriented
- Critical thinking and problem solving
- Accountability, adaptability and flexibility
- Motivated and ability to learn quickly
- Energetic and ability to take constructive feedback
- Ability to work in a production focused environment
- Good verbal and communication skills
- NASCO claim adjusting
- Knowledge in the use of Careradius, Encoder, EviCore, Predictal and INSINQ
- Lotus notes where the medical policy database and OTT are housed
Validation Specialist
Fresenius Kabi
Maricao
04.2021 - 12.2023
- Validated testing methods and equipment to ensure compliance with regulations.
- Developed protocols for method and instrument validation, enhancing operational efficiency.
- Coordinated report preparation and investigations through effective collaboration.
- Documented validation processes while recording all changes meticulously.
- Scheduled validation testing across departments to optimize resource use.
- Communicated complex technical data clearly to non-engineering stakeholders.
- Managed supplier performance indicators and verified material compliance with specifications.
- Supported Microbiology Lab investigations through adherence to established procedures.
Laboratory Tech
Fenwal Fresenius
Maricao
01.2001 - 01.2021
- Executed biological, environmental, and critical system tests per specifications and procedures.
- Supported Environmental, Safety, and Health initiatives to achieve organizational objectives.
- Monitored distilled and non-distilled water systems for compliance and quality assurance.
- Conducted process and method validations to ensure operational integrity.
- Performed Bioburden testing on plant components, bags, solution mixing tanks, and finished goods.
- Prepared biological indicators for validation of Maricao vessels, ensuring adherence to standards.
- Knowledge in EO (Ethylene Oxide) sterilization
- Maintained microorganism flora identification to support laboratory protocols.
- Supervised cleaning and maintenance of laboratory equipment to minimize errors.
Education
Bachelor's Degree - Biology
Interamerican University
Aguadilla, PR, US07.1995
Skills
- Validation master plans
- Equipment calibration
- Effective communication
- Record keeping
- Process analysis
- Mathematical proficiency
- Regulatory guidelines
- Testing protocols
- Test case development
- Audit processes
- Analytical thinking
- Quality assurance methods
- GMP knowledge
- SAP proficiency
- Claim processing accuracy
- Medical policy review
- Regulatory compliance testing
- Continuous improvement strategies
- Healthcare claims adjudication
- CPT and ICD coding
- Collaboration skills
- Detailed documentation practices
- Critical thinking skills
- Problem solving abilities
- Clear communication skills
- Teamwork effectiveness
- Adaptability in fast-paced environments
- Verbal and written communication skills
- Staff mentoring and coaching techniques
- Data entry accuracy
- Client confidentiality management
- Process documentation practices
- Reporting and documentation standards
- Lean Six Sigma methodologies
- Team leadership capabilities
- Goal setting strategies
- Cost reduction initiatives
Certification
- Certified Yellow Belt, Fresenius Kabi
- GMP, Fresenius Kabi
- Process Validation for Medical Devices
References
Available upon request
Languages
- English
- Spanish
Languages
English
Native
Native
Spanish
Proficient (C2)
C2
Timeline
Senior Process Associate
Infosys
01.2024 - Current
Validation Specialist
Fresenius Kabi
04.2021 - 12.2023
Laboratory Tech
Fenwal Fresenius
01.2001 - 01.2021
Bachelor's Degree - Biology
Interamerican University