Lizbeth Vargas Villanueva
Las Piedras
Summary
Dynamic professional with extensive experience at Alivia Health in claims validation and management. Proven expertise in ICD-10 coding and exceptional customer service skills, driving successful authorization outcomes. Adept at problem-solving and document management, ensuring efficient processes and high patient satisfaction in fast-paced environments.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Coverage Determination Floater
Alivia Health
Guaynabo, Puerto Rico
10.2024 - Current
- Claims validation and management of Part B authorizations.
- ICD-10 codes management.
- Part B and PBM management insurances.
- Customer service for medical offices and patients.
- Document management for insurance.
Case Management Specialist
SPS Specialty Pharmacy
Caguas, Puerto Rico
03.2018 - 07.2022
- Data entry: patient profile, Rx management, documentation, and insurance process.
- Customer service for patients and medical offices.
- ICD-10 management Part B and PBM.
- Claims and Part B authorizations management.
- PAP (Patient Assistance Program Services) copay cards and foundation management.
- Follow up with insurance companies and medical offices for medication approval.
- Home care or infusion center appointment management.
- LDD cases management (Xtandi).
Education
Associate of Science - Pharmacy Technician
Huertas College
Caguas11-2016
High School Diploma -
Ramon Power And Giralt
Las Piedras05-2013
Skills
- ICD-10 coding
- Claims management
- Document management
- Customer service
- Insurance verification
- Data entry
- Authorization processing
- Patient assistance programs
- Effective communication
- Time management
- Attention to detail
- Team collaboration
- Problem solving
Languages
Spanish
First Language
English
Elementary (A2)
A2
Certification
- Pharmacy Technician License
Timeline
Coverage Determination Floater
Alivia Health
10.2024 - Current
Case Management Specialist
SPS Specialty Pharmacy
03.2018 - 07.2022
Associate of Science - Pharmacy Technician
Huertas College
High School Diploma -
Ramon Power And Giralt
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