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Rosangelica Diaz

@rosangelicadiaz

Message

I help patients navigate pharmacy benefits, prior authorizations, claims, and access to care.

United States

Message

What I'm looking for

I'm looking for a healthcare patient advocacy or care coordination role where I can help members navigate benefits, prior authorizations, claims, medication access, and barriers to care while improving the patient experience.

At AffirmedRx, I help patients and members navigate pharmacy benefits, insurance coverage, formularies, deductibles, copays, and medication access. I coordinate with physicians, pharmacies, insurers, and specialty pharmacies to resolve barriers that could delay treatment.

Previously at UnitedHealthcare, I supported members with benefits, eligibility, billing, treatment authorizations, claims, and explanations of benefits. I researched complex concerns, applied plan requirements and CMS/Medicare guidelines, and followed issues through resolution.

I also brought clinical, administrative, and team-lead experience from Signature Healthcare and Carney Hospital. I support patients with referrals, insurance approvals, prior authorizations, appeals, medical claims, scheduling, and clear education in both English and Spanish.

Experience

Work history, roles, and key accomplishments

Current

Patient Care Advocate

Current

AffirmedRx

Oct 2025 - Present (11 months)

Provide patient and member advocacy by helping individuals navigate complex pharmacy benefits, insurance coverage, formularies, deductibles, copays, and out-of-pocket costs. Coordinate with physicians, pharmacies, insurers, and other healthcare partners to resolve barriers that could delay treatment.

Patient Advocacy Pharmacy Benefits Insurance Coverage Payer Formularies Deductibles Co Pay Prior Authorizations Appeals Salesforce PALogic HIPAA Care Coordination Medication Access Patient Education

UM/R Customer Service First Responder

UnitedHealthcare

May 2024 - Nov 2025 (1 year 6 months)

Provided telephonic support to health plan members regarding benefits, eligibility, billing, payments, treatment authorizations, claims, and explanations of benefits. Researched healthcare claims and verified benefits, pricing, prior authorization requirements, and other information necessary for processing.

Customer Service Claims Processing Benefits Eligibility Billing Prior Authorizations Medicare Medicaid CMS Guidelines Familiarity problem resolution Documentation Healthcare Systems

Medical Assistant Team Lead / Medical Administrative

Signature Healthcare

Aug 2021 - May 2024 (2 years 9 months)

Supported patients throughout clinical and administrative healthcare processes while serving as an advocate and point of contact. Coordinated patient appointments, referrals, medication requests, insurance approvals, and follow-up services.

Medical Assisting Patient Advocacy Care Coordination Prior Authorizations Appeals Medicare Medicaid Vital Signs Medication Reconciliation Claims Processing Billing Training Team Leadership

Medical Assistant Team Lead / Customer Service Representative

Carney Hospital

Provided clinical, administrative, and customer service support to patients in a hospital environment. Assisted with patient check-in/check-out, scheduling, appointment reminders, insurance verification, and telehealth enrollment.