Irma

Ramirez

**** ******** ** *** *******, TX **250

210-***-****

ponceuma93@g mail.com

Knowledgeable in administrative assistant with 2 years’ experience and document representative in the legal field with 7 years of experience, billing specialist and collections with 10 years’ experience, high energy, self-motivated, self-starter with the ability to work under stress, I have extensive experience working in many high paced and high-pressure environments maintain excellent work and productive relationship with my co-workers and clients, I have a good and strong communication, organizational, and bilingual skills in English/Spanish both oral and written, strong technical background and ability to use the knowledge in an accurate manner. Responsible, honest, loyal, respectful, and could prove to be a valuable member of the team.

Employment History

Consultants in Pain Medicine

Billing Specialist/Collections: June 2018 to July 2019

Daily Duties: Collection calls and/or correspondence in a fast paced goal oriented collections department providing excellent customer services regarding collection issues, process customer refunds, process and review account adjustments, resolve client discrepancies and short payments. Responsible for monitoring and maintaining assigned accounts, Accountable for reducing delinquency on assigned account. Perform other assigned task and duties as necessary to support the Accounts Receivable Department. Enlist the efforts of sales and senior management when necessary to accelerate the collection process. Establish and maintain effective relationships with clients.

Gonzaba Medical Group/Call Center

Call Center: February 2018 – May 2018

Daily Duties: Receiving and making calls to patients with a volume of 80 – 90 per day for 20 MD, 8PA-C, 4BC, 1DPM, and 1 CNC, for 7 locations. Scheduling for all and providing excellent customer care service to members and staff including sending refills to pharmacists. Demographic updates, uploading paperwork to members profiles. Verifying insurance, Updating changes to profiles. .

Superior Health Plan

Project Coordinator: Aug 2017-Dec 2017.

Participate in client interactions, coordinate core analysis activities and projects for effectively maintaining both verbal and written communication as needed, throughout the life cycle of the project; advise clients of analytical services, providing support, meeting objectives, assist in tool synergy and process refinement to ensure effective and maintained relationships. Facilitate project scope, project surveillance and schedule development maintenance requirements; as well as, track schedules to the task level; work well with others in order to ensure the needs of all clients and fellow team member projects are successfully met and maintained. Proficient in the use of Microsoft Office software and have the ability to learn company needed software. Responsible for the initiation of complex core analysis projects and coordination of the projects through the life cycle of the analytical project program.

Wellmed Medical Management

Utilization Management Coordinator/Claims Processor: February 2015- March2017.

Coordinates initial screening for UM claim reviews through claim queue, email and fax, Monitors UM inventory to ensure adherence to CMS regulations. Maintains knowledge of Health Plan benefits, network, CMR regulations and WellMed Policies, meets/exceeds departmental timeframes and quality metrics on a consistent basis. Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions, outpatient services, focused surgical and diagnostic procedures, out of network services, and appropriateness of treatment setting Applies clinical knowledge to work with facilities and providers for care coordination. Worked with medical directors in interpreting appropriateness of care and accurate claims, managing appeals for services denied.

Santa Rosa Children hospital/Christus Santa Rosa

Patient Access

Specialist/Team Lead:

October 2011- Feb 2015

I currently work in a fast paced call center, providing centralized scheduling, currently receiving all the orders that our send from the medical providers to the call center for scheduling which includes contact with the medical providers, medical clients, advocates, contractors, indexing the orders to Santa Rosa system, view orders daily, making corrections if needed, maintain communication between physicians, staff, patients and assist physicians staff with procedures and insurances that required authorizations, as MRI, CT, Renal, EEG, EKG, ultrasounds, medical screening children and

adults. Verify major commercial insurances and government insurances, as well as, Managed Medicare and Medicaid to ensure the revenue cycle flows from the point of scheduling through pre-registration.

Radiology Associates of SA, PA

Billing Specialist/Collections: February 2007- July 2010

Managed customer services skills, answering patients calls English/Spanish, taking credit card payment and making refunds, billing major and Medicaid carriers insurances, including verification of insurances, Verify NPI information in system and patients for billings, and research on high dollar accounts for appeals (gathering correct documentation) gathering patient medical reports for worker comp billing, strong technical skills and knowledge in billing. Strong organizational, task prioritization, and delegation skills.

Professional skills

Word 2000, outlook, MS word 6.0, 7.0, 97 and 2010, ms excel 2013, windows XP, medisoft, omega system, TruCare, IKA, realmeal, Meditech, software, passport, e.care/Nebo, medical terminology, printers, scanners, copiers, faxing, data base programs, Program work Amisys, Provider Demographic, Portico, Nppes, compliance 360, Microsoft Dynamics CRM, Pega/Cenpas.

Education

South Gate High school Graduated: 1993 Cerritos College general degree: 93-95