Customer Service Case Manager
Resume:
Karina Adela Ayala
www.linkedin.com/in/karina-ayala-0b0133133
Portland, OR
adzyd5@r.postjobfree.com
SKILLS
Bilingual - Spanish
Communication
Active listening
Adaptability
Resourceful
Teamwork/Collaboration
Leadership
Conflict Resolution
Time Management
Customer Service
Detail-oriented
Problem solving
Critical-thinking
Organization
Conflict Resolution
Transferability
Professional Presentations
EDUCATION
Bachelor’s of Science
Business Management
Grand Canyon University
Phoenix, AZ
2021
Medical Interpreting Training School – Spanish
2022
SUMMARY
Determined, self-motivated and patient focused. With 4 years of health and customer service experience, going above and beyond for individuals, increasing customer satisfaction, and providing support and education to patients and families.
PROFESSIONAL EXPERIENCE
Case Manager (Contractor) April 2023 - Present
Genentech, Portland OR
Liaison between patients, providers, distributors and
insurance carriers to assure services are provided in the least restrictive and least costly manner.
Provides customer focused reimbursement support to patients, pharmacists, physicians and internal sales force.
Educates, informs, and assists patients and providers to navigate through the reimbursement process for the assigned product.
Identifies barriers to reimbursement and continually identifies and recommends program efficiencies to the Supervisor to promote high quality of work by Access Solutions/Genentech Patient Foundation staff.
Identifies and facilitates referrals to alternative coverage options and financial assistance programs for patients who are under insured or require copy assistance.
Establishes relationships with appropriate stakeholders including internal and external partners.
May conduct necessary benefits, coverage and payer research/investigations to ensure appropriate resources, compliance with payer appeal policies, practices, timelines.
Educates, informs and generally assists patients and their families, as well as other related external or internal parties on how to navigate the appeals process.
Patient Resource Specialist (Contractor) July 2022 – April 2023
Genentech, Portland OR
Representing the company as the first point of contact for callers with questions about the products, assistance and providing resources.
Analyzing the most effective next steps in successfully resolving calls, using a large breadth of processes and procedures, while utilizing access to multiple systems and databases.
Receive calls via internal company transfers from multiple sources, including Genentech Reception, Corporate Relations, Access Solutions, and Customer Service.
Provide Genentech’s technical phone support for My Patient Solutions for HCP offices, Case Managers, Foundation Specialists, and Field Reimbursement Managers.
Karina Adela Ayala
EDUCATION CONTINUED
High School Diploma
Ocean View Christian Academy
San Diego, CA
2016
TECHNICAL SKILLS
TalkDesk proficient
PACT Software
CRM Software
Microsoft/Google Suites
WPM – 62
PROFESSIONAL EXPERIENCE continued
Supply Sales Specialist II April 2021 – July 2022
Tandem Diabetes Care, San Diego, CA
Inquiring that all documents, information, and privacy is under all legal, regulatory, HIPAA, and safety requirements.
Coordinating customer shipments via email, SMS, and phone calls.
Handling order pipelines through CRM, within the process and shipment deadline.
Collecting insurance information and completing benefit investigations for customers and explaining coverage and benefits.
Submitting/renewing authorization requests to medical offices.
Working with department leads to ensure needs are met in the processing and shipment stage.
Handling any escalated situations and effectively communicating and providing solutions to customers.
Managing activities to maximize time and effort on the job to achieve daily metrics.
Outbound Specialist December 2020 – April 2021
Tandem Diabetes Care, San Diego, CA
Inquiring that all documents, information, and privacy is under all legal, regulatory, HIPAA, and safety requirements.
Coordinating customer shipments via email, SMS, and phone calls.
Handling order pipelines through CRM, within the process and shipment deadline.
Collecting insurance information and completing benefit investigations for customers and explaining coverage and benefits.
Submitting/renewing authorization requests to medical offices.
Working with department leads to ensure needs are met in the processing and shipment stage.
Handling any escalated situations and effectively communicating and providing solutions to customers.
Managing activities to maximize time and effort on the job to achieve daily metrics.
Contact this candidate